Corresspondence to:
Vizeshfar, Fatemeh- Mehdizadeh, Kadege
Nursing Faculty of Shiraz Medical Science University
Zeinab Nursing Collage
Tell:(098-781-2241251)
Fax:(098-781-2247111)

For a long time during the twentieth century, the women's health care focused mainly on reproductive functions as periodic cycle, pregnancy, delivery and menopause; however, there was a basic change in the attitude by 1990. It should be noted that women's health is actually associated with their lives' cultural, social and biological dimensions. By 1990, regulations were developed in terms of women's health issues throughout the world. Longevity among women is higher than men, and they should be supported to promote these extra years of lifetime from the point of view of health care. However success in each health planning program depends upon the cooperation of the subjects themselves
(22, pp:562-565).

One is, individually, responsible for one's health, though, it's a basic right for human being. It means that is not the official or social health services which keep the people healthy; it is achieved just through the individual attempts.

People should accept a range of responsibilities, related to their health, called "self-care". The concept is referred to as a range of health-maintaining proceedings done by the individual.

It mainly includes activities to prevent diseases and to promote health, such as, dietary regimen, sleep, exercise, body weight control, habits and style of life, immunity, screening, and preventing the diseases by consulting the physicians in time. Therefore it's necessary for the women, regarding their age, to do the self-care behaviors (1, pp: 55-56). The specific objective concerning women's health and screening is to prevent and control various kinds of cancer such as breast cancer, reproductive tract cancers like genitalia, AIDS, and diseases such as Anemia, Steoprosis, chronic low back pains and violence (22, pp: 562-565).

The most common cancer among women is breast cancer, with which one out of nine people are affiliated.In IRAN It also forms 12.6 percent of all cancers and it is more common among the women aged 35-years old and higher.

The diagnosis of cancer is increasing because of its Mamography. At present, because of the restrictions of primary prevention, focusing on secondary prevention, namely, in time diagnosis is of significant importance. Several studies have revealed that screening through clinical examination of the breast and mammography are effective in diagnosing breast cancer⁽²⁵⁾. In addition, women who do the self-exam of their breasts have more chances to diagnosis the disease. 19 percent of the deaths due to breast cancer occur because ignoring mammography.

Cervical cancer is considered the second common cancer among women throughout the world. Life expectancy is 66 percent, and if it's diagnosed in time, it would increase to 100 percent for 5 years of life expectancy. The manifestation of cervical cancer maximizes at the age of 45 through 55 years. Pap smears is the main screening test for cervical cancer. A decrease in mortality rate in cervical cancer during the last 50 years has been due to the use of pap smear (1, pp: 55-56).

In America, 20 percent of women suffer from during pregnancy. According to a study, in America women between 12-50 years and at risk receive just half of the necessary iron (2, pp: 201-222). Accordingly, international women health society suggests that screening tests should be continued while aging⁽²⁶⁾.

Hypertention is considered as one the most important risk factors in heart diseases and the most common factor of heart/kidney failure in CVA (cardio vascular accident). In most countries, consequently, international woman's health community recommended that screening tests should be followed as women grow older.

Hypertension is one of the main factors in heart diseases and the current previlage factor in CHF, and CVA. In many countries one out of four is suffusing from hypertension. In American 25% of men and 21% of women are afflicted with hypertension.(2pp:201-222)There fore the people's awareness of hypertension and planning to control if is of significant importance.

Considering the importance of blood cholesterol in developing croner vascular diseases and variety of studies such as Framingham in American it is suggested that the 20- year-old indicate and over do the Lippopratein test every five years or with less interval if there is any family background Auother screening test is Measuring density of bone⁽¹⁹⁾.

Those who use steroids for a long time, women inmenopaue age, those who smoke and those with a background with fracture are prove to steoprosis and frequent fractures should have enough knowledge in this regard.

Since certain cultural and social factors can affect women's health and Odditionally self care behavior varies in different communities, this study can help women to pramote.
Knowledge and abilities in self-care with attention to the age groups through planning for necessary (helpful) education.

This study is a cross sectional survey conducted to evaluate knowledge and self-care behavior among women.

Through cluster and random sampling, 607 women referring to the medical centers in northan, Southern central, Vestbrn and eastern parts of Shiraz, were studied. The subjects were studied to determine their knowledge and self care behaviors related to preventing cervicalcancer AIDS , Breast cancer hypertension high cholesterol rate. anemia steoprosis and relationship between knowledge and self-care behavior with women Demographic character: stice.

The questianare consisting of two parts of demography features and questionnaire todetermine their knowledge and practice related to self care was distributed and based on their responses to the questions it was divided into 3 groups of good, average, and weak.

The data were analyzed using SPSS package and description analysis of variance one way anova and t-test.

The results of this study revealed that 60.8% (369 people) Of the subjects were among women of 20-30 years old, 7.1% lower than 20 years and 8.9% over 40 years old. 67.8 of the subjects (404) get married when they were than 20 years of age.

86.6% of the were housewives.the most of them 77.9% (472) of the degree Diplom and less were 7.6% (46) illiterate and 14.5% higher education.

45.3% (275) had only one child and just 6.4 (36) had no child. Regarding subjects' knowledge of self-care behaviors in the table 1 depicts 91.1% (553) were aware of the ways to control chlostrol, 88.3 (536) aware of AIDS prevention.

73.1% (444) of anemia Symptom, 60.3% (366) of the ways to prevent steoprosis 41.5% (355) were aware of the ways to diagnose steoporosis and just 23.2 (141) had knowledge of the age of testing steoporosis. 21.6% (131) were aware of the ways to prevent disease and 17.1 (104) knew the age to momography test.

As shown in table 2, 71%(431) knew how to measure hypertention 64.9,(394) blood chlostrol and 59.6(362) cheked pap smear and 51.9 (315) tested for anemia, pelvis examination was done by 32.1 (195), breast self exunination done by 27.8 according to the this tabl. Blood BP measure has been done more than other screening tests. Table 3 shows the fulfillment of screening test with proper intervals. According to the table, BP measure had the most frequency, then pap smear 34.1(207) blood cholestral16.6 (101) .

Blood cholesterol 16.6. pelvis examination 15.8 breast self eam:natio11.6(10) and mammography, table 4 depicts the level of knowledge of subjects about self-care behaviors which statistically shows that among the subjects 52.2 (317) had good knowledge, 38.7 average, and 9.1 (55) had weak knowledge about self-care behavior.

Practically, 59.5 (361) of the subjects had weak practice, about self care 37.4 (227) were average and just 3.1% (19) had good practice. Table 5 shows the frequency of density of practice about self care.

Table 6 shows that the majority of subjects gain their information through several sources as mass-media (Radio/TV) health care centers, and relatives or friends.

One way variance analysis showed that there is a meaningful relationship between knowledge (f=15, p= 000) level of education (f=47, p= 000), number of children (f=3.2, p=0.2), and t-test shows a meaningful relationship between knowledge and the occupation of the subjects(p=0.000).

Analysis of variance also showed that there is meaningful relationship between practice and age (f=44.9, p=0.000) number of children (f=12.4, p=0.000) and level of education(p=0.000) from and t-test showed that this significant relationship exists between knowledge and occupation on the other hand.

In order to maintain health, self-care is one of the basic needs in our community. Skill in self-care determines the quality of life and longevity. Self-care begins from family members and society to gain, maintain and promote health. Since human body is constantly changing physiologically and these natural changes lead to disorder, it's necessary for women to have knowledge about health fullness and maintain it and fulfill screening tests as they grow older.

This study revealed 73.1% of the subjects were aware of AIDS and the ways of its prevention and its commune. In Enosolease's study in Nigeria, 100% of women who illegal had experience abortion, and in Ekanem study in Nigeria, 89.9% of pregnant women, and in hesketh' study in China the majority of health care staff were aware of AIDS.

The reason for this similarity indicate great international attempts to enhance people's knowledge of the importance and dangers of AIDS specially women. Lee Chung et al in their study on the relation of Anti-body test of HIV and its acceptance by people from Hongkong cause to this conclusion that having knowledge about HIV can increase the fulfillment of screening test for AIDS.

The other finding of this study was that 91.1% of the subjects were aware of the ways to control blood cholesterol but only 16.6% of them did the test in proper interval. In order to control the level of blood cholesterol, a blood random sampling for screening the level of cholesterol and HDL amony the individuals above 20 year old and its should be repeated every 5 years if the normal ragne is present(3pp:70). Although the subjects were aware of the importance of blood cholesterol in cardio vascular diseases, a few of them had done the related test. Maybe it is because the subjects were mostly young. However, the individuals should be encourage to do the screening test.

Artineain (2004) in his study on American and Mexicans revealed that the majority of subjects used up more fried high fat foods and cookies and less fruits, vegetables and diaries. Inactivity, obesity and smoking are the main factors in cardio vascular disease development.
Researches emphasize the importance of nutrition in preventing cardio vascular diseases and doing screening test⁽⁶⁾.

Artiniein in this study also revealed that 63.1% of the subjects under the study had knowledge about the dangers of hypertension and that was measurement by 71%, showing that the highest figures are related to screening tests.

It is recommended that women above 21year check their BP every 2 years in case it's done and with less interval if there is evidence of Border line hypertension or if there is High Bpond History of BP in the family⁽¹⁹⁾. Though the frequency of checking BP in screening tests among the subjects was more than that in the other tests. Regarding the point that all subjects were expeecting pregnancy, and its routine that this BP is checked during this period may be the case.

Since people's knowledge and practice plays a significant role in decreasing cardio vascular disease, it's necessary to plan specific and widespread program.

A plan called Healty heart was conducted in Isfahan to decrease the cardio vascular diseases through controlling risk factors and enhancing health behaviors during which the subject's FBS, cholesterol and thri glycride were measured⁽²³⁾ primary steoprosis May happen at either sex or at any age which secondary steoprosis happens because of using drugs or due to disease on the other hand, this is a widespread disease through out the world and may people are suffering this dangerous disease. Therefore in order to decrease any fracture during the middle aged years, the bones should be solidated since childhood another finding .of this study was knowledge about early detection of breast cancer

64.1% of the women had knowledge of mammography, and 7.1% knew the age of the test 27.8% of them fulfilled breast self-examination but only 7.1% had done it regularly. It's helpful for the women between 20-39 years old to do clinical examination of the breast every 3 years and 40 years old and above anualy and mamography for the women of 40 years and above once or twice a year⁽¹⁹⁾.

Azizi suggests breast self-examination, montly, for the women above 20 Alwash (2001) in his study in UAI showed that women had not enough knowledge about breast cancer. The results indicated that 12.1% or the subjects had done Breast Self-exam and 10.3% of them had done mammography⁽¹⁷⁾. Ahmad stewart (2004) in their study in canada showed that 8.5% of the subjects, mostly imigrants had done brest clinical exam and it also remaind that the older women had more knowledge about BC showing more interest for doing the tests⁽⁴⁾.

Smokin's (2004) on American couloured skin irimigrant women's revealed that 54% of them hadn't done Mamography during the last 15 months The simulatian between the results can be due to identically of the subjects from the point of view of social economical status.

Since Breast cancer is considered one of the main cancers of women and on the other hand, it will be with and treated if it is diagnosed of the early stage, the role of health staff to do Breast cancer screening test in considerable. They should incouraged and educating women to do.

A study in canada showed after of education about Breast cancer , 70.8% of the imigrant women had done cyclic checks and 59.7% of the breast cyclic exams. And also there was an increase in the average scores of their knowledge from 3.3% to 7%⁽⁵⁾.

Of course, in addition to planning and interfereing in creating a positive attitude Breast self examinatia . screening tests and evaluating women's knowledge of the tests in educational and cultural framework, the rate of facilities accessibility and Satisfaction in doing screening test are also crucial.

In smokin's study (2005), there was a positive between relationship and pap smears test, from one increasing in age private insurance agents having knowledge of the health center and satisfaction during the care the other hand⁽²⁵⁾. Of the 59.6% of the subjects of the study who had tested pap smear only 34.1% of them had done the test regularly. It's recommended that the were with sexual activities should do pap smear test till 70 years old and if negative for 3 times, do it each 3 year.

Mandelblatt, et al (2002) revealed in their study that 80% of cervical cancer occur in developing countries, where there is no organized and programmed screening test. Pap smear is an effective way in decreasing mortality rate due to cervical cancer. Through pap smear in addition to HPV test during a five year period among the women between 20-70 years old has decreased 90% of mortality rate due to cervical cancer⁽¹⁷⁾. Gitangi&et. al (2003) in a study in Kenia showed that 51% of the subjects participating in the study were aware of cervical cancer while 22% had done.

In another study conducted by McFarland& et .al (2003) having low knowledge of cervical cancer and pap smears test 40% of the never had done pap smear⁽¹⁸⁾, and in this regard in the study done by Kim in American on Korea women, 26% of the subjects had not been aware of aware the name of the test (PS)pap smear and 34% of the had done the test⁽¹⁴⁾. The reasons for identification of the results can be attributed to the similarity in socioeconomic class, level of education and race.

Some of the main problems for doing screnning test include economic and cultural factor,low levelof education and the existence of no insurance for women. Someother problems include lack of knowledge in women, health care staff's negative attitude and time restructure of physicians for doing research.

Education and health care are effective in the increasing of the knowledge away women and improving their practice, and healthcare staff play an important role in screening based on culture and ethical principles⁽¹⁴⁾.

Breast cancer The most prevalent kind of cancer among the women and nearly one out of nine of women is suffering for breast cancer. Breast cancer in Iran is prevalent among the women aged 35 and higher 6.6 people in thousand and 12.6 percent of all the cancer.

Prognosis has been increased because of mamography during the recent years. Because of limitation in primary prevention, attention should be paid to secondary prevention which 13 immediate diagnosis.

A large number of studies have revealed that mamography and clinical examination of the breast are effective measures to discover breast cancer in time. 19% percent of the death due to breast cancer happen because of not doing mamography. In addition the women who test their breast have the chance to discover breast cancer in early stages.

Cervical cancer is the second main cancer prevailing among women through the world. Servival rate is 66% percent and can enhance to 100% percent it is discovered in time. Cervical cancer happens maximally till 45-55 years. Pap smears the main test for screening of Cervical cancer decrease in time. mortality rate due to Cervical cancer during the last 50 years because of in time diagnosis using pap smears.

20% of women in fertility ages are suffering from anemia.
According to a study in American women between 12-50 years to anemia receive just half of the necessary Fe.

The findings of this study showed that only 21.6% of the subjects knew the prevention ways of the diseases. Because of this important role in the family in different aspect of promoting health (individual/heath care right nutrition exercise stress control…), women should received enough and necessary information in these area, nurses and the health workers must teach and encourage women about self care behavior and Screening tests.

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