Questionnaire regarding cervical cancer prevention
Age:
Education:≤ 6 years (Elementary)
7-9 years (High School)
10-12 years (Lyceum)
≥ 12 years (Tertiary)
Occupation:Farming sector
Unemployed
Public sector
Education Entrepreneur
Health sector
Private sector
Housewife
Retired
Place Village (<5000 people)
of residence:Town (5001-25000 people)
City (>25000 people)
Net family≤ €1000 /month
income:€1000-€2000 /month
€2000-€3000 /month
≥ €3000 /month
FamilySingle
Status:Married
Widow
Divorced
Parity
Number of male children
Age of male children
Number of female children
Age of female children
How many times per year do you visit your Gynaecologist?None
Once
2-3 times
> 3 times
Have you ever used oral contraceptive pills?Yes/No
If yes, how long have you used the pill for?
Do you smoke?Yes /No
If yes, for how long have you been a smoker?
≤ 1 year
1-5 years
5-10 years
10 years
How many cigarettes do you smoke per day?
Do you know what the Pap test is?Yes/No
Are you aware of the reasons why women should have Pap test?Yes/No
If yes, what do you think are the reasons women should have Pap test?
… to prevent cancer in general
… to prevent cancer of genitalia
… to prevent cancer of the vulva
… to prevent cancer of the endometrium
… to prevent cancer of the ovaries
… to prevent cancer of the cervix
… to prevent cancer of the fallopian tubes
… to prevent cancer of the breast
Have you ever had Pap test?Yes/No
If not, the reason I have never had pad Pap test is because …
… I was not informed
… I was feeling insecure
… I was afraid of the results
… I was ignorant
… I had not time
… I had no access to Pap test services
… I was embarrassed to have the examination
… I have no symptoms
… I have more serious things to do
If yes, how often have you had Pap test
Once
2-3 times
Regularly (yearly for the last 5 years)
Last time you had Pap test was
<12 months ago
1 – 3 years ago
> 3 years ago
Have you ever had an abnormal Pap test?Yes/No
Do you have a friend who had an abnormal Pap test?Yes/No
Do you have a friend who had cervical cancer?Yes/No
Where from did you have information about Pap test?
From family
From friends
From your gynaecologist
From TV
From newspapers / magazines
From the internet
From other sources
Where from did you have information about cervical cancer?
From family
From friends
From your gynaecologist
From TV
From newspapers / magazines
From the internet
From other sources
Cervical cancer has a causative relation to…
Age
Diet
Sexual activity
Hygiene
Air pollution
Viral infection
Microbial infection
I do not know
Is cervical cancer a preventable disease?
No
Yes, a little
Yes, a lot
I do not know
How do you think cervical cancer can be prevented?
Healthy diet
Quit smoking
Conservative sexual life
Pap test
Frequent gynaecological examination
Medication
Other ways
I do not know
How many Greek women (%) do you think have Pap test regularly?
100%
80%
50%
30%
20%
10%
5%
I do not know
Is cervical cancer is a curable disease?
No
Yes, to some extent
Yes, largely
I do not know
Cervical cancer is
A very frequent disease
A frequent disease
An uncommon disease
A very rare disease
How many women do you think that are dying daily from cervical cancer in Europe?
None
One
Ten
Fifty
A hundred
Three hundred
Do you know what Human Papilloma Virus (HPV) is?Yes/No
If yes, where from did you have information about HPV?
From family
From friends
From your gynaecologist
From TV
From newspapers / magazines
From the internet
From other sources
How is HPV transmitted?
Food
Air
Sexual partner
Animals
Toilets
Towels
HPV comes from yourself
From heredity
Through other sources
I do not know
What is the result of an infection from HPV?
HPV infection
Always causes cervical cancer
Sometimes causes cervical cancer
Regresses spontaneously
I do not know
Do you know what HPV test is?Yes/No
Have you ever had HPV test?Yes/No
Do you have a friend who had an HPV test?Yes/No
Are you aware of the HPV vaccine?Yes/No
Where from did you obtain information about the HPV vaccine?
From family
From friends
From your gynaecologist
From TV
From newspapers / magazines
From the internet
From other sources
Would you accept to be vaccinated against HPV in order to prevent an HPV infection?
Yes/No
If not, the reasons are…
… insufficient information
… potential side-effects from vaccine
… I believe vaccine does not protect against HPV
Would you accept to be vaccinated against HPV in order to prevent cervical cancer?
Yes/No
If not, the reasons are…
… insufficient information
… I don’t believe HPV is the reason of cervical cancer
… potential side-effects from vaccine
… I believe vaccine does not protect against HPV
Would you agree to have you daughter vaccinated against HPV?
Yes/No
If not, the reasons are…
… insufficient information
… potential side-effects from vaccine
… she does not need vaccination
… I don’t believe HPV is the reason of cervical cancer
… I believe vaccine does not protect against HPV
… I don’t believe my daughter will get cervical cancer
Would you agree to have you son vaccinated against HPV?
Yes/No
If not, the reasons are…
… insufficient information
… potential side-effects from vaccine
… he does not need vaccination
Would you agree to have you son vaccinated against HPV to prevent cervical cancer from his future partners?
Yes/No
If not, the reasons are…
… insufficient information
… I don’t believe HPV is the reason of cervical cancer
… potential side-effects from vaccine
… I believe vaccine does not protect against HPV
… future partners do not need protection
Who should administer HPV vaccine to adults?
Gynecologists
Family doctor
Pediatrician
Pharmacist
Nurse
Midwife
Who should administer HPV vaccine to adolescent girls <16-years-old?
Gynecologists
Family doctor
Pediatrician
Pharmacist
Nurse
Midwife
Who do you trust to administer HPV vaccine to adolescent girls <16-years-old?
Gynecologists
Family doctor
Pediatrician
Pharmacist
Nurse
Midwife
Internist
Where do you think HPV vaccination should take place?
School
Hospital
Health center
Private clinics
Office
Pharmacy
Home
Do you think the girl (the boy) should be informed prior to vaccination?
Yes/No/Do not know
Do you think the public should be informed about HPV-cervical cancer relation?
Yes/No/Do not know
Do you think Gynecologists are informed about HPV?
Yes/No/Do not know
Do you think Pediatricians are informed about HPV?
Yes/No/Do not know
If HPV vaccine was not free of charge, would you purchase it by your own means?
Yes
No
Only if the cost was partially covered by the state
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