The Relationship among Demographic and Personal Characteristics, Health Beliefs, and Colonoscopy-Related Embarrassment

Friday, 17 July 2009: 8:30 AM

Kimberly A. Mitchell
Nursing, Saint Francis Medical Center College of Nursing, Peoria, IL
Susan Rawl, PhD, RN
School of Nursing, Indiana University, Indianapolis, IN

Learning Objective 1: discuss the demographic/personal characteristics and health beliefs of the sample that were significantly related to colonoscopy embarrassment and colonoscopy compliance.

Learning Objective 2: state the factors that were predictive of colonoscopy embarrassment and compliance with colonoscopy.

Purpose: Colorectal cancer (CRC), the third leading cause of cancer-related death in the U.S., could be prevented if more people had polyps removed via colonoscopies. Embarrassment has been identified as one important barrier to colonoscopy compliance, but little is known about embarrassment in this context. The purposes of this study were to: 1) examine relationships among demographic/personal characteristics, health beliefs, and Colonoscopy Embarrassment Scale (CES) scores, and 2) examine relationships among demographic/personal characteristics, health beliefs, physician recommendation, CES scores, and colonoscopy compliance. The Health Belief Model and Transtheoretical Model of Change were the theoretical underpinnings of this study.

Methods: Participants were HMO members aged 50-65 years (n=234). Using a cross-sectional, descriptive research design, data were collected using a mailed survey. The response rate was 56%. Data were analyzed using independent samples t-tests, correlations, and regression.

Results: Lower income, higher BMI, lower CRC knowledge, higher barriers, and lower self-efficacy were related to higher CES scores. Higher BMIs and higher barriers were predictive of higher CES scores. Higher CRC knowledge, lower barriers, very high self-efficacy, and a physician recommendation for the test were related to higher compliance with colonoscopy. Lower barriers, very high self-efficacy, and a physician recommendation were predictive of compliance with colonoscopy.

Conclusion: Embarrassment is a significant barrier to colonoscopy, yet there are steps that can be taken to reduce embarrassment such as increasing privacy and limiting bodily exposure. The CES is a tool that can be used to measure colonoscopy-related embarrassment and the results could be used in developing further interventions to reduce embarrassment, leading to increased colonoscopies and lower mortality.