title: The utilization and barriers of Pap smear among women with visual impairment.
abstract: BACKGROUND
  Many evidences illustrate that the Pap smear screening successfully reduces if the cervical cancer could be detected and treated sufficiently early. People with disability were higher comorbidity prevalence, and less likely to use preventive health care and health promotion activities. There were also to demonstrate that people with visual impairment has less access to appropriate healthcare services and is less likely to receive screening examinations. In Taiwan, there was no study to explore utilization of Pap smear, associated factors and use barriers about Pap smear screening test among women with visual impairment. The purpose is to explore the utilization and barriers of using Pap smear for women with visual impairment in Taiwan. To identify the barriers of women with visual from process of receiving Pap smear screening test.
  
  
  METHODS
  The cross-sectional study was conducted and the totally 316 participators were selected by stratified proportional and random sampling from 15 to 64 year old women with visual impairment who lived in Taipei County during December 2009 to January 2010. The data was been collected by phone interview and the interviewers were well trained before interview.
  
  
  RESULTS
  The mean age was 47.1 years old and the highest percentage of disabled severity was mile (40.2 %). Totally, 66.5 % of participators were ever using Pap smear and 38.9 % used it during pass 1 year. Their first time to accept Pap smear was 38.8 year old. There was near 50 % of them not to be explained by professionals before accepting the Pap smear. For non-using cases, the top two percentage of barriers were "feel still younger" (22.3 %), the second was "there's no sexual experience" (21.4 %). We found the gynecology experiences was key factor for women with visual impairment to use Pap smear, especially the experiences was during 1 year (OR = 4).
  
  
  CONCLUSIONS
  Associated factors and barriers to receive Pap smear screening test for women with visual impairment can be addressed through interventions aimed at improving on cognitions and attitudes for cervical cancer risk factors. Our study would be as a reference resource for erasing the barriers and inequality among the visually disabled women.
authors.affiliation: Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-Hui
authors.initials: WH
authors.lastname: Fang
authors.affiliation: Department of Public Health, Tzu-Chi University, Hualien, Taiwan. mapleyeng@gmail.com.
authors.forename: Chia-Feng
authors.initials: CF
authors.lastname: Yen
authors.affiliation: Medical Quality Department, E-DA Hospital, Kaohsiung, Taiwan.
authors.forename: Jung
authors.initials: J
authors.lastname: Hu
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Jin-Ding
authors.initials: JD
authors.lastname: Lin
authors.affiliation: Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Loh
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014786:Vision Disorders / Q000150:complications* / Q000523:psychology
keywords: Barriers; Pap smear screening; Utilization; Women with visual impairment