{
    "abstract": "In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers' behaviour in examining women who present with abnormal discharge or bleeding.\nThis was a cross-sectional survey using the theory of planned behaviour (TPB). A sample of primary health care practitioners in western Kenya completed a 59-item questionnaire. Structural equation modelling was used to identify the determinants of providers' intention to perform a gynaecological examination. Bivariate analysis was conducted to investigate the relationship between the external variables and intention.\nDirect measures of subjective norms (DMSN), direct measures of perceived behavioural control (DMPBC), and indirect measures of attitude predicted the intention to examine patients. Negative attitudes toward examining women had a suppressor effect on the prediction of health workers' intentions. However, the predictors of intention with the highest coefficients were the external variables being a nurse (\u03b2\u2009=\u20090.32) as opposed to a clinical officer and workload of attending less than 50 patients per day (\u03b2\u2009=\u20090.56). In bivariate analysis with intention to perform a gynaecological examination, there was no evidence that working experience, being female, having a lower workload, or being a private practitioner were associated with a higher intention to conduct vaginal examinations. Clinical officers and nurses were equally likely to examine women.\nThe TPB is a suitable theoretical basis to predict the intention to perform a gynaecological examination. Overall, the model predicted 47% of the variation in health care providers' intention to examine women who present with recurrent vaginal bleeding or discharge. Direct subjective norms (health provider's conformity with what their colleagues do or expect them to do), PBC (providers need to feel competent and confident in performing examinations in women), and negative attitudes toward conducting vaginal examination accounted for the most variance. External variables in this study also contributed to the overall variance. As the model in this study could not explain 53% of the variance, investigating other external variables that influence the intention to examine women should be undertaken.",
    "authors": [
        {
            "affiliation": "Department of Reproductive Health, School of Medicine, Moi University, Box 4606, Eldoret, 30100, Kenya. waleghwaem@hotmail.com.",
            "firstname": "Emily",
            "initials": "E",
            "lastname": "Mwaliko"
        },
        {
            "affiliation": "Epidemiology and Social Medicine, Social Epidemiology and Health Policy, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.",
            "firstname": "Guido",
            "initials": "G",
            "lastname": "Van Hal"
        },
        {
            "affiliation": "Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Gouverneur Kinsbergen Centrum, Doornstraat 331 - 2610 Wilrijk, Antwerp, Belgium.",
            "firstname": "Hilde",
            "initials": "H",
            "lastname": "Bastiaens"
        },
        {
            "affiliation": "Department of Biology, Evolutionary Ecology Group, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium.",
            "firstname": "Stefan",
            "initials": "S",
            "lastname": "Van Dongen"
        },
        {
            "affiliation": "DVC Academic Research & Extension, Technical University of Mombasa, Mumbasa, Kenya.\nGhent University, Ghent, Belgium.",
            "firstname": "Peter",
            "initials": "P",
            "lastname": "Gichangi"
        },
        {
            "affiliation": "Department of Surgery, School of Medicine, Moi University, P.O. Box 4606, Eldoret, 30100, Kenya.",
            "firstname": "Barasa",
            "initials": "B",
            "lastname": "Otsyula"
        },
        {
            "affiliation": "Department of Sociology Psychology and Anthropology, School of Arts and Social Sciences, Moi University, P.O. Box 3900, Eldoret, 30100, Kenya.",
            "firstname": "Violet",
            "initials": "V",
            "lastname": "Naanyu"
        },
        {
            "affiliation": "Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.\nDepartment of Obstetrics and Gynaecology, Aga Khan University, P O. Box 00100, Nairobi, Kenya.",
            "firstname": "Marleen",
            "initials": "M",
            "lastname": "Temmerman"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1186/s12875-021-01395-y\n10.1371/journal.pmed.0050132\n10.1136/ijgc-00009577-200311000-00014\n10.1186/s12905-015-0167-4\n10.1016/S0968-8080(08)32399-4\n10.1016/j.ejon.2010.06.003\n10.1016/j.socscimed.2004.08.050\n10.1186/1757-1626-1-62\n10.1136/bmj.f3251\n10.1016/S0738-3991(00)00104-X\n10.1111/j.1365-2354.2011.01259.x\n10.1016/S0968-8080(08)32415-X\n10.1590/S0036-36342009000800018\n10.3399/bjgp14X680125\n10.1186/1748-5908-6-55\n10.1176/ps.2007.58.3.342\n10.1363/3802006\n10.1348/135910701169250\n10.1111/j.1752-7325.2012.00353.x\n10.3109/10826084.2014.952446\n10.1207/s15327906mbr2603_7\n10.1016/0749-5978(91)90020-T\n10.5688/aj720111\n10.1186/1748-5908-3-36\n10.1186/1748-5908-7-99\n10.1186/1748-5908-7-53\n10.1016/j.ijgo.2010.11.011\n10.1038/bjc.2014.65\n10.1245/s10434-014-4344-8\n10.3389/fonc.2016.00160\n10.1136/bmjopen-2015-008533\n10.4314/ahs.v13i4.28\n10.1186/1478-4491-11-64\n10.1186/s12960-015-0073-8",
    "journal": "BMC family practice",
    "keywords": [
        "Abnormal uterine bleeding",
        "Cervical cancer",
        "Early detection",
        "Health care providers",
        "Health care seeking delays",
        "Kenya",
        "Primary health care",
        "Theory of planned behaviour"
    ],
    "methods": null,
    "publication_date": "2021-03-13",
    "pubmed_id": "33706721\n11682945\n18563963\n14675320\n25783641\n19027618\n20673743\n15950092\n18655728\n23737266\n20811526\n11118780\n21771126\n19027621\n19967283\n24868072\n21619689\n17325107\n16554268\n12614509\n22762414\n25438029\n26776715\n18322573\n18631386\n23075284\n22682656\n21345435\n24518600\n25605513\n27446806\n26853214\n26754174\n24940332\n24325763\n26358250",
    "results": "Direct measures of subjective norms (DMSN), direct measures of perceived behavioural control (DMPBC), and indirect measures of attitude predicted the intention to examine patients. Negative attitudes toward examining women had a suppressor effect on the prediction of health workers' intentions. However, the predictors of intention with the highest coefficients were the external variables being a nurse (\u03b2\u2009=\u20090.32) as opposed to a clinical officer and workload of attending less than 50 patients per day (\u03b2\u2009=\u20090.56). In bivariate analysis with intention to perform a gynaecological examination, there was no evidence that working experience, being female, having a lower workload, or being a private practitioner were associated with a higher intention to conduct vaginal examinations. Clinical officers and nurses were equally likely to examine women.",
    "title": "Early detection of cervical cancer in western Kenya: determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding.",
    "xml": "<Element 'PubmedArticle' at 0x78850720f470>"
}