Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine

H. Öztürk Şahin; Özgür Özerdoğan; Mehmet Nuri Duran

doi:10.22391/fppc.639212

Araştırma Makalesi

Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine

Yıl 2020, Cilt: 5 Sayı: 3, 69 - 75, 16.11.2020

H. Öztürk Şahin , Özgür Özerdoğan , Mehmet Nuri Duran

https://doi.org/10.22391/fppc.639212

Cited By: 5

Öz

Introduction: HPV (Human papilloma virus) is the most common sexually transmitted infection and constitutes an important part of cancers for which infectious agents are blamed in its ethology. The most important duty of informing the public about HPV and the HPV vaccine with a high protection rate belongs to doctors. The curriculum and scope of this subject in medical education in our country is uncertain. We aimed to determine the knowledge, attitudes, and behaviours of our students about HPV and the HPV vaccine before the internship and to find out the change in their knowledge, attitudes, and behaviour status after the internship.

Method: The population of the study consists of a total of 257 third and sixth grade students studying in the Faculty of Medicine at Çanakkale Onsekiz Mart University during the 2018-2019 academic year. A questionnaire, including questions and suggestions about sociodemographic characteristics, and knowledge, attitudes and behavioural status about HPV infection and the HPV vaccine, was administered under supervision to third and sixth grade students between April and June 2019 without specifying their name and surname. Chi-square test was used for statistical evaluation. For statistical significance, p <0.050 was accepted.

Results: 108 third grade and 91 sixth grade students participated in our study. Although HPV is known to play a role in the ethology of cervical cancer and anogenital warts (91%, 91.2%), this awareness was as low as 35.4%, 37.9% and 38.8%, respectively, in penis, anus and head and neck cancers. The knowledge level was statistically significant in favour of the sixth-grade students (p <0.001). When the attitudes and behaviours of the students were examined, the frequency of having the HPV vaccine was 4.5%. It was observed that the frequency of the idea of vaccination among the female students was higher than that of the male students (61.3%, 18.1%). No statistically significant difference was found among the possible variables that could affect the need for the HPV vaccine when compared according to the gender, grade, and the educational status of the mother or father (p> 0.05). The reason why the students did not have the HPV vaccine was related to the fact that they found the vaccine expensive and did not consider it necessary. Only 46.7% of the sixth-grade students thought that they could give their patients enough information about the HPV virus and vaccine when they graduated.

Conclusion: The frequency of vaccination in our country is very low even among doctors. Training strategies should be developed to enable doctors to graduate with full knowledge of HPV and the HPV vaccine with multidimensional training programs.

Anahtar Kelimeler

Papillomavirus infections, internship and residency, papillomavirus vaccines, medical students, health knowledge, attitudes

Kaynakça

1. Centers for Disease Control and Prevention. Genital HPV infection-fact sheet.2016. Available at: http://www.cdc.gov/std/hpv/stdfact-hpv.htm (Access date: August 2, 2019)
2. Centers for Disease Control and Prevention (CDC) Human papillomavirus-associated cancers - United States, 2004–2008. MMWR Morb Mortal Wkly Rep 2012;61:258–61. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a2.htm (Access date: April 20, 2012)
3. Hartwig S, Syrjanen S, Dominiak Felden G, Brotons M, Castellsague X. Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe: a review. BMC Cancer. 2012;12:30. https://doi.org/10.1186/1471-2407-12-30
4. Martinez Fierro ML, Leach RJ, Gomez Guerra LS, Garza-Guajardo R, Johnson Pais T, Beuten J, et al. Identification of viral infections in the prostate and evaluation of their association with cancer. BMC Cancer. 2010;10:326. https://doi.org/10.1186/1471-2407-10-326
5. Centers for Disease Control and Prevention. HPV vaccine information for clinicians. 2016. Available at: https://www.cdc.gov/vaccines/news/newsltrs/imwrks/2019/2019-07.html (Access date: August 2, 2019)
6. Brotherton JML, Bloem PN. Population-based HPV vaccination programs are safe and effective: 2017 update and the impetus for achieving better global coverage. Best Pract Res Clin Obstet Gynaecol. 2018;47:42-58. http://dx.doi.org/10.1016/j.bpobgyn.2017.08.010
7. Blasi PR, King D, Henrikson NB. HPV Vaccine Public Awareness Campaigns: An Environmental Scan. Health Promot Pract 2015;16(6):897-905. https://doi.org/10.1177%2F1524839915596133
8. Ersan G, Kose S, Gunes H, Ozkan M. Knowledge and awareness of female sex workers towards human papillomavirus infection in Turkey. Cent Eur J Public Health 2012;20(3):219-22. https://www.ncbi.nlm.nih.gov/pubmed/23285524
9. Ozyer S, Uzunlar O, Ozler S ,Kaymak O, Baser E, Gungor T , et al. Awareness of Turkish female adolescents and young women about HPV and their attitudes towards HPV vaccination. Asian Pac J Cancer Prev 2013;14(8):4877-81. .http://dx.doi.org/10.7314/apjcp.2013.14.8.4877
10. Dursun P, Altuntas B, Kuscu E, Ayhan A. Women’s knowledge about human papillomavirus and their acceptance of HPV vaccine. Aust N Z J Obstet Gynaecol 2009;49(2):202-6. http://dx.doi.org/10.1111/j.1479-828X.2009.00947.x
11. Afonso NM, Kavanagh MJ, Swanberg SM, Schulte JM, Wunderlich T, Lucia VC. Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students. BMC Public Health 2017;17(1):35. http://dx.doi.org/10.1186/s12889-016-3969-x.
12. Gilkey MB, Moss JL, Coyne-Beasley T, Hall ME, Shah PD, Brewer NT. Physician communication about adolescent vaccination: How is human papillomavirus vaccine different? Prev Med 2015;77:181-5. https://doi.org/10.1016/j.ypmed.2015.05.024
13. Kulczycki A, Qu H, Shewchuk R. Primary Care Physicians' adherence to guidelines and their likelihood to prescribe the human papillomavirus vaccine for 11- and 12-year-old girls. Womens Health Issues 2016; 26(1):34–9. https://doi.org/10.1016/j.whi.2015.07.012
14. Wiley R, Shelal Z, Urbauer D, Bernard C, Ramondetta L. Relationship between intent to vaccinate and the education and knowledge of human papillomavirus among medical school faculty and students in Texas. Tex Med. 2019;115(1):e1. https://ncbi.nlm.nih.gov/30601572/
15. Luryi, AL, Yarbrough, WG, Niccolai, LM, Roser S, Reed SG, Nathan CA, et al. Public awareness of head and neck cancers: a cross-sectional survey. JAMA Otolaryngol Head Neck Surg 2014;140(7):639-46. https://doi:10.1001/jamaoto.2014.867
16. Cesmeci Y, Koylu B, Sulaiman J, Sancak E, Senel S, Baki HE , et al. HPV infection and HPV vaccine through the eyes of interns. Turkish J Gynecol Oncol 2015;18(3):85-92. Available at: https://dergipark.org.tr/tr/pub/trsgo/issue/36053/404733 (Access date: January 30,2016)
17. Daniel CL, McLendon L, Green CL, Anderson KJ, Pierce JY, Perkins A, Beasley M. HPV and HPV vaccination knowledge and attitudes among medical students in Alabama. J Cancer Educ 2019. https://doi:10.1007/s13187-019-01613-3
18. Wanderley MDS, Sobral DT, Levino LA, Marques LA, Feijó MS, Aragão NRC. Students' HPV vaccination rates are associated with demographics, sexuality, and source of advice but not level of study in medical school. Rev Inst Med Trop Sao Paulo 2019;61:e70. https://doi.org/10.1590/s1678-9946201961070
19. Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017;92(19):241-68. English, French. https://apps.who.int/10665/255354
20. Schnaith AM, Evans EM, Vogt C, Tinsay AM, Schmidt TE, Tessier KM, Erickson BK. An innovative medical school curriculum to address human papillomavirus vaccine hesitancy. Vaccine 2018;36(26):3830-5. https://doi.org/10.1016/j.vaccine.2018.05.014

Tıp fakültesi öğrencilerinin HPV ve HPV aşısı ile ilgili bilgi, tutum ve davranışları

Yıl 2020, Cilt: 5 Sayı: 3, 69 - 75, 16.11.2020

H. Öztürk Şahin , Özgür Özerdoğan , Mehmet Nuri Duran

https://doi.org/10.22391/fppc.639212

Cited By: 5

Öz

Giriş: HPV (Human papilloma virüs) seksüel yolla bulaşan en sık enfeksiyondur ve etiyolojisinde enfeksiyon ajanlarının suçlandığı kanserlerin önemli bir bölümünü oluşturmaktadır. HPV ve koruyuculuk oranı bir hayli yüksek HPV aşısı ile ilgili toplumu bilgilendirmede en önemli görev doktorlara düşmektedir. Ülkemizde tıp eğitiminde bu konu ile ilgili müfredat programı ve kapsamı belirsizdir. Biz de öğrencilerimizin staj öncesi HPV ve HPV aşısı hakkındaki bilgi, tutum ve davranışlarını ve staj sonrası konu ile ilgili değişim durumlarını saptamayı amaçladık.

Yöntem: Çalışmanın evrenini Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi 2018-2019 Bahar Yarıyılı Eğitim Öğretim Döneminde eğitim almakta olan 3. ve 6. sınıf toplam 257 öğrenci oluşturmaktadır. 3. ve 6.sınıf öğrencilerine, Nisan-Haziran 2019 tarihleri arasında, gözetim altında, ad soyadı belirtilmeden, sosyodemografik özellikleri ve HPV enfeksiyonu ile HPV aşısı hakkında bilgi, tutum, davranış durumunu sorgulayan soruları/önermeleri içeren soru formu uygulanmıştır. İstatistiksel değerlendirmede ki-kare testi kullanılmıştır. İstatistiksel anlamlılık için p<0,05 kabul edilmiştir.

Bulgular: Çalışmamıza 3. Sınıf 108, 6. Sınıf 91 öğrenci katılmıştır. Bilgi düzeyinde HPV’nin serviks kanseri ve anogenital siğil etiyolojisinde rol oynadığının yüksek oranda bilinmesine rağmen (%91 ve %91,2); penis, anüs ve baş boyun kanserinlerinde bu farkındalık sırasıyla %35,4, %37,9 ve %38,8 gibi düşük oranlardaydı. Bilgi düzeyi 6. sınıf öğrencileri lehine istatistiksel olarak anlamlıydı(p<0,001). Öğrencilerin tutum ve davranış durumu incelendiğinde HPV aşısı yaptırmış olma sıklığı %4,5’ti. Kız öğrencilerinde aşıyı yaptırma düşüncesinin erkek öğrencilerden daha yüksek olduğu görüldü (%61,3, %18,1). HPV aşısının gereklilik düşüncesini etkileyebilecek olası değişkenler arasında düşündüğümüz cinsiyet, sınıf, anne veya babanın lise ve yüksek okul eğitim durumuna göre karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı (p>0,05). HPV aşısını yaptırmayan öğrencilerin yaptırmama nedeni olarak ilk sırayı pahalı olması ve gerekli görmeme almaktaydı. Altıncı sınıf öğrencilerinin sadece %46,7’sinin mezun olduğunda HPV virüsü ve aşısı hakkında hastalarına yeterli bilgiyi verebileceğini düşündüğü ifade etti.

Sonuç: Ülkemizdeki aşılanma sıklığı hekimler arasında bile çok düşüktür. Birincil önceliği koruyucu hekimlik olan aile hekimi adayları, HPV ve aşısı hakkında çok yönlü eğitim programları ile tam bir bilgi birikimi ile mezun olmalıdır.

Anahtar Kelimeler

Papilloma virüsü enfeksiyonları, ön hekimlik, papilloma virüsü aşıları, tıp öğrencileri, sağlık bilgisi, tutumlar

Kaynakça

1. Centers for Disease Control and Prevention. Genital HPV infection-fact sheet.2016. Available at: http://www.cdc.gov/std/hpv/stdfact-hpv.htm (Access date: August 2, 2019)
2. Centers for Disease Control and Prevention (CDC) Human papillomavirus-associated cancers - United States, 2004–2008. MMWR Morb Mortal Wkly Rep 2012;61:258–61. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a2.htm (Access date: April 20, 2012)
3. Hartwig S, Syrjanen S, Dominiak Felden G, Brotons M, Castellsague X. Estimation of the epidemiological burden of human papillomavirus-related cancers and non-malignant diseases in men in Europe: a review. BMC Cancer. 2012;12:30. https://doi.org/10.1186/1471-2407-12-30
4. Martinez Fierro ML, Leach RJ, Gomez Guerra LS, Garza-Guajardo R, Johnson Pais T, Beuten J, et al. Identification of viral infections in the prostate and evaluation of their association with cancer. BMC Cancer. 2010;10:326. https://doi.org/10.1186/1471-2407-10-326
5. Centers for Disease Control and Prevention. HPV vaccine information for clinicians. 2016. Available at: https://www.cdc.gov/vaccines/news/newsltrs/imwrks/2019/2019-07.html (Access date: August 2, 2019)
6. Brotherton JML, Bloem PN. Population-based HPV vaccination programs are safe and effective: 2017 update and the impetus for achieving better global coverage. Best Pract Res Clin Obstet Gynaecol. 2018;47:42-58. http://dx.doi.org/10.1016/j.bpobgyn.2017.08.010
7. Blasi PR, King D, Henrikson NB. HPV Vaccine Public Awareness Campaigns: An Environmental Scan. Health Promot Pract 2015;16(6):897-905. https://doi.org/10.1177%2F1524839915596133
8. Ersan G, Kose S, Gunes H, Ozkan M. Knowledge and awareness of female sex workers towards human papillomavirus infection in Turkey. Cent Eur J Public Health 2012;20(3):219-22. https://www.ncbi.nlm.nih.gov/pubmed/23285524
9. Ozyer S, Uzunlar O, Ozler S ,Kaymak O, Baser E, Gungor T , et al. Awareness of Turkish female adolescents and young women about HPV and their attitudes towards HPV vaccination. Asian Pac J Cancer Prev 2013;14(8):4877-81. .http://dx.doi.org/10.7314/apjcp.2013.14.8.4877
10. Dursun P, Altuntas B, Kuscu E, Ayhan A. Women’s knowledge about human papillomavirus and their acceptance of HPV vaccine. Aust N Z J Obstet Gynaecol 2009;49(2):202-6. http://dx.doi.org/10.1111/j.1479-828X.2009.00947.x
11. Afonso NM, Kavanagh MJ, Swanberg SM, Schulte JM, Wunderlich T, Lucia VC. Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students. BMC Public Health 2017;17(1):35. http://dx.doi.org/10.1186/s12889-016-3969-x.
12. Gilkey MB, Moss JL, Coyne-Beasley T, Hall ME, Shah PD, Brewer NT. Physician communication about adolescent vaccination: How is human papillomavirus vaccine different? Prev Med 2015;77:181-5. https://doi.org/10.1016/j.ypmed.2015.05.024
13. Kulczycki A, Qu H, Shewchuk R. Primary Care Physicians' adherence to guidelines and their likelihood to prescribe the human papillomavirus vaccine for 11- and 12-year-old girls. Womens Health Issues 2016; 26(1):34–9. https://doi.org/10.1016/j.whi.2015.07.012
14. Wiley R, Shelal Z, Urbauer D, Bernard C, Ramondetta L. Relationship between intent to vaccinate and the education and knowledge of human papillomavirus among medical school faculty and students in Texas. Tex Med. 2019;115(1):e1. https://ncbi.nlm.nih.gov/30601572/
15. Luryi, AL, Yarbrough, WG, Niccolai, LM, Roser S, Reed SG, Nathan CA, et al. Public awareness of head and neck cancers: a cross-sectional survey. JAMA Otolaryngol Head Neck Surg 2014;140(7):639-46. https://doi:10.1001/jamaoto.2014.867
16. Cesmeci Y, Koylu B, Sulaiman J, Sancak E, Senel S, Baki HE , et al. HPV infection and HPV vaccine through the eyes of interns. Turkish J Gynecol Oncol 2015;18(3):85-92. Available at: https://dergipark.org.tr/tr/pub/trsgo/issue/36053/404733 (Access date: January 30,2016)
17. Daniel CL, McLendon L, Green CL, Anderson KJ, Pierce JY, Perkins A, Beasley M. HPV and HPV vaccination knowledge and attitudes among medical students in Alabama. J Cancer Educ 2019. https://doi:10.1007/s13187-019-01613-3
18. Wanderley MDS, Sobral DT, Levino LA, Marques LA, Feijó MS, Aragão NRC. Students' HPV vaccination rates are associated with demographics, sexuality, and source of advice but not level of study in medical school. Rev Inst Med Trop Sao Paulo 2019;61:e70. https://doi.org/10.1590/s1678-9946201961070
19. Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017;92(19):241-68. English, French. https://apps.who.int/10665/255354
20. Schnaith AM, Evans EM, Vogt C, Tinsay AM, Schmidt TE, Tessier KM, Erickson BK. An innovative medical school curriculum to address human papillomavirus vaccine hesitancy. Vaccine 2018;36(26):3830-5. https://doi.org/10.1016/j.vaccine.2018.05.014

Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Kadın Hastalıkları ve Doğum
Bölüm	Araştırma Makalesi (Original Article)
Yazarlar	H. Öztürk Şahin 0000-0002-7915-8235 Özgür Özerdoğan 0000-0003-2176-9073 Mehmet Nuri Duran 0000-0001-6925-711X
Yayımlanma Tarihi	16 Kasım 2020
Gönderilme Tarihi	28 Ekim 2019
Kabul Tarihi	15 Ekim 2020
Yayımlandığı Sayı	Yıl 2020 Cilt: 5 Sayı: 3

Kaynak Göster

APA	Şahin, H. Ö., Özerdoğan, Ö., & Duran, M. N. (2020). Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine. Family Practice and Palliative Care, 5(3), 69-75. https://doi.org/10.22391/fppc.639212
AMA	Şahin HÖ, Özerdoğan Ö, Duran MN. Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine. Fam Pract Palliat Care. Aralık 2020;5(3):69-75. doi:10.22391/fppc.639212
Chicago	Şahin, H. Öztürk, Özgür Özerdoğan, ve Mehmet Nuri Duran. “Knowledge, Attitudes, and Behaviors of Medical Students Regarding HPV and HPV Vaccine”. Family Practice and Palliative Care 5, sy. 3 (Aralık 2020): 69-75. https://doi.org/10.22391/fppc.639212.
EndNote	Şahin HÖ, Özerdoğan Ö, Duran MN (01 Aralık 2020) Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine. Family Practice and Palliative Care 5 3 69–75.
IEEE	H. Ö. Şahin, Ö. Özerdoğan, ve M. N. Duran, “Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine”, Fam Pract Palliat Care, c. 5, sy. 3, ss. 69–75, 2020, doi: 10.22391/fppc.639212.
ISNAD	Şahin, H. Öztürk vd. “Knowledge, Attitudes, and Behaviors of Medical Students Regarding HPV and HPV Vaccine”. Family Practice and Palliative Care 5/3 (Aralık 2020), 69-75. https://doi.org/10.22391/fppc.639212.
JAMA	Şahin HÖ, Özerdoğan Ö, Duran MN. Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine. Fam Pract Palliat Care. 2020;5:69–75.
MLA	Şahin, H. Öztürk vd. “Knowledge, Attitudes, and Behaviors of Medical Students Regarding HPV and HPV Vaccine”. Family Practice and Palliative Care, c. 5, sy. 3, 2020, ss. 69-75, doi:10.22391/fppc.639212.
Vancouver	Şahin HÖ, Özerdoğan Ö, Duran MN. Knowledge, attitudes, and behaviors of medical students regarding HPV and HPV vaccine. Fam Pract Palliat Care. 2020;5(3):69-75.