Differential Impact of Education Level, Occupation and Marital Status on Performance of the Papanicolaou Test among Women from Various Regions in Brazil

Background: In Brazil, little is known regarding the underlying causes of differences among populations regarding socio-economic variables that affect women's cervical cancer screening behavior. The present study focused on socio-economic variables that affect women's performance of the Papanicolaou test, comparing two distinct Brazilian populations. Methods: We collected data regarding performance of the Papanicolaou test and socio-economic variables from 559 women in Mato Grosso do Sul (MS), in the Central East region, and 338 women in Paraíba (PB), in the Northeast region of Brazil. Nominal logistic regression modeling was performed to identify independent variables for both groups of data. Results: Of the women interviewed from MS and PB, 116 out of 599 (19.37%) and 94 out of 338 (27.81%), respectively, had not performed the Papanicolaou test within the last three years (p = 0.025). Low educational level characterized 570 (95.16%) and 203 (60.06%) of women from MS and PB, respectively (p = 0.000). Women in PB who had a low educational level and were unemployed had a 2.96-fold (OR = 0.338; 95% CI: 0.121 - 0.939) and 2.40-fold (OR = 0.416; 95% CI: 0.199 - 0.869) lower chance, respectively, to have performed the Papanicolaou test ≥ three times, or once within the last three years (p = 0.029; p = 0.014). The chance of women in MS who did not live in a stable relationship to have performed the test ≥ three times was 1.79-fold (OR = 0.560; 95% CI: 0.348 ­ 0.901) lower compared to women who reported a stable relationship (p = 0.039). Conclusions: High educational level, employment, and having a stable interpersonal relationship positively associated with performance of the Papanicolaou test among women in PB and MS. Despite having predominantly a low educational level, women in MS performed the Papanicolaou test more frequently than those in PB.

Fatores emocionais associados ao hábito de fumar em usuários de um programa antitabagismo / Emotional factors associated with smoking in individuals enrolled in a tobacco cessation program / Factores emocionales asociados con el hábito de fumar de usuarios de un programa de cesación de tabaquismo

Objetivo: Caracterizar a população atendida por um programa de tratamento do tabagismo e identificar os fatores emocionais associados ao hábito de fumar. Métodos: Estudo transversal, realizado em 2016, com dados secundários extraídos dos registros do programa de tratamento do fumante do município de Água Clara, Mato Grosso do Sul, Brasil. Os dados analisados referem-se a 173 participantes que realizaram a entrevista inicial do programa, de janeiro de 2012 a setembro de 2015. Foram estudadas as variáveis: sexo, idade, história tabagística, grau de dependência da nicotina, fatores emocionais e outras condições de saúde-doença. Analisaram-se os dados por meio de estatística descritiva, e a associação do grau de dependência aos fatores emocionais foi analisada pelo teste exato de Fisher. Resultados: Verificou-se a predominância do sexo feminino (63,6%, n=110); com idade média de 45,99 anos; média de idade de início do hábito de fumar de 14,38 anos; e média de tempo de uso do cigarro de 31,62 anos. Dos sintomas apresentados, predominaram os transtornos emocionais (75,1%, n=130), com confirmação de 38,2% (66) para depressão. Com relação ao grau de dependência da nicotina, 68,2% (118) apresentaram grau "elevado ou muito elevado", sendo observada associação entre nível "elevado e muito elevado" de dependência e fatores emocionais, como ansiedade e depressão (p<0,05). Conclusão: Os participantes do programa são mulheres em idade adulta, com tempo prolongado de uso do cigarro e decorrente presença de comprometimentos na saúde. Foi observada associação entre fatores emocionais como ansiedade e depressão e o maior grau de dependência da nicotina.

Objective: To characterize the population enrolled in a smoking treatment program and to identify the emotional factors associated with smoking. Methods: Cross-sectional study carried out in 2016 using secondary data extracted from the records of a smoking treatment program in the municipality of Água Clara, Mato Grosso do Sul, Brazil. The data analyzed refer to 173 participants who had undergone the initial interview of the program from January 2012 to September 2015. The following variables were studied: gender, age, smoking history, degree of nicotine dependence, emotional factors and other health-disease conditions. The data were analyzed using descriptive statistics, and the association between the degree of dependence and emotional factors was analyzed using Fisher's exact test. Results: There was a predominance of women (63.6%, n=110), with a mean age of 45.99 years, mean age of onset of smoking of 14.38 years and mean time of cigarette use of 31.62 years. Of the symptoms presented, emotional disorders were predominant (75.1%, n=130), with a 38.2% (66) rate of depression. Regarding the degree of nicotine dependence, 68.2% of the participants presented high or very high levels, with an association between high and very high levels of dependence and emotional factors such as anxiety and depression (p<0.05). Conclusion: The program participants are adult women with a long time of cigarette use and consequently compromised health. There was an association between emotional factors and a greater degree of nicotine dependence.

Objetivo: Caracterizar la población asistida por un programa para tratamiento del tabaquismo e identificar los factores emocionales asociados al hábito de fumar. Métodos: Estudio transversal realizado en 2016 con los datos secundarios de registros del programa de tratamiento para fumadores del municipio de Agua Clara, Mato Grosso do Sul, Brasil. Los datos analizados son de 173 participantes que realizaron la entrevista inicial del programa entre enero de 2012 y septiembre de 2015. Se estudiaron las variables sexo, edad, historia de tabaco, grado de dependencia de nicotina, factores emocionales y otras condiciones de salud-enfermedad. Se analizaron los datos a través de la estadística descriptiva. La asociación del grado de dependencia y los factores emocionales ha sido analizada por el test exacto de Fisher. Resultados: Se verificó la predominancia del sexo femenino (63,6%, n=110) con la media de edad de 45,99 años; la media de edad del inicio del hábito de fumar de 14,38 años; y la media del tiempo de consumo de cigarro de 31,62 años. Entre los síntomas presentados hubo predominancia para los trastornos emocionales (75,1%, n=130) y la confirmación del 38,2% (66) de depresión. Respecto el grado de dependencia de nicotina el 68,2% (118) presentaron grado "elevado o muy elevado" con asociación entre el nivel "elevado y muy elevado" de dependencia y los factores emocionales como la ansiedad y la depresión (p<0,05). Conclusión: Los participantes del programa son mujeres en edad adulta con largo uso del cigarro y la presencia de problemas de salud. Se observó la asociación entre los factores emocionales y el mayor grado de dependencia de nicotina.