[Perceived barriers to taking a Pap smear: predictors in immigrant women].

BACKGROUND: New immigrant women in Taiwan are believed to generally perceive that "no illness" infers good health. Because medical inspection induces feelings of discomfit and due to language barriers, limited/no insurance coverage and more limited access to medical resources, understanding better the motivation of immigrant women to take Pap smears, the actual examination rate and key factors that influence willingness is important. Coverage of this issue, however, is extremely limited in domestic research. PURPOSE: This study aimed to investigate: (i) The Pap smear screening rate amongst immigrant women; (ii) Immigrant women's perception of cervical cancer susceptibility and severity as well as cues to action and perceived barriers to taking a Pap smear; and (iii) Predictors of perceived barriers to taking Pap smears in this target population. METHODS: Using a cross-sectional descriptive correlation study design, 100 immigrant women were recruited from the outpatient clinic and inpatient wards of a regional teaching hospital in Kaohsiung. Structured questionnaires included a demographic survey, scales of susceptibility and cervical cancer severity, scales of cues to action and barriers to receiving a Pap smear. RESULTS: One-quarter (25%) of the surveyed population had never taken a Pap smear. Immigrant women perceived their knowledge somewhat insufficient with regard to cervical cancer susceptibility and severity. Level of education, previous Pap smear experience, and number of children represented significant predictors of perceived barriers in taking Pap smears, accounting collectively for 26.1% perceived variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings suggest that appropriate interventions should be targeted on the general healthcare population as well as tailored to specific immigrant national populations in order to improve Pap smear screening rates amongst immigrant women.

Neonatal readmission within 2 weeks after birth.

To examine the causes of neonatal readmission within two weeks of discharge and identify the factors associated with neonatal readmission, newborns readmitted to Kaohsiung Municipal Hsiao-Kang (KMHK) Hospital within two weeks of discharge from our nursery between October 2001 and November 2003 were studied retrospectively. Of the 1099 deliveries during the study period, there were 63 newborns readmitted to KMHK Hospital within 14 days of discharge, with a rate of 5.7%. The control group consisted of a systematic sampling of newborns delivered over the same period that were not readmitted (n=74). The diagnoses of readmission included jaundice (73.0%), fever and suspected sepsis (19.0%), enteritis (4.8%), and others (3.2%). Factors associated with readmission included length of stay in nursery less than 72 hours, exclusive breast feeding, more body weight loss, and higher bilirubin level at discharge from nursery. After multiple logistic regression analysis, length of stay in nursery less than 72 hours, exclusive breast feeding and higher bilirubin level at discharge from nursery were the significant risk factors for neonatal readmission.