title: Association between Pap smear screening and job stress in Taiwanese nurses.
abstract: OBJECTIVE
  Nursing is a professional job characterized by high stress. Stress could be associated with less practice of health promoting behaviors; however, no study has investigated the relationship between job stress and health screening behaviors among nurses. This study aimed to describe the rate of Pap smears in hospital nurses and examine the effects of job stress on receiving a Pap smear.
  
  
  METHODS
  This study was a cross-sectional survey. The study participants were 30,681 full-time female nurses who were at least 30 years of age working in 100 hospitals across Taiwan. The study participants filled out an anonymous structured questionnaire from May to July, 2011. The outcome variable was having a Pap test during the previous 3 years. The level of stress was measured by a 19-item scale, with higher scores indicating higher stress levels.
  
  
  RESULTS
  About 62.4% of the nurses had a Pap smear during the previous three years. Each point increase in the stress score decreased the likelihood of Pap smears (OR = .997, 95% CI: .995-.999), after adjustment for participant characteristics, health status, health behaviors, and hospital characteristics.
  
  
  CONCLUSIONS
  Despite more knowledge and higher accessibility, nurses were less likely to have Pap smear screening than the general population. A higher level of job stress was associated with a lower likelihood of having a Pap smear. Hospital administrators could help decrease work-related stress and improve stress adaption among nurses in order to improve their health screening behaviors.
authors.affiliation: Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan; Deparment of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: s52syzel@gmail.com.
authors.forename: Shiang-Yuan
authors.initials: SY
authors.lastname: Su
authors.affiliation: Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. Electronic address: stchiou@hpa.gov.tw.
authors.forename: Shu-Ti
authors.initials: ST
authors.lastname: Chiou
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. Electronic address: syhuang@ym.edu.tw.
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
authors.affiliation: Department of Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: cmhuang@ym.edu.tw.
authors.forename: Chiu-Mieh
authors.initials: CM
authors.lastname: Huang
authors.affiliation: Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan. Electronic address: zinvii@gmail.com.
authors.forename: Jen-Huai
authors.initials: JH
authors.lastname: Chiang
authors.affiliation: Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan. Electronic address: lychien@ym.edu.tw.
authors.forename: Li-Yin
authors.initials: LY
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D065006:Papanicolaou Test / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan; D002583:Uterine Cervical Neoplasms / Q000523:psychology*; D014626:Vaginal Smears / Q000523:psychology*; D000066477:Work Performance
keywords: Job stress; Nurses; Pap smear; Screening behavior