The Influence of Health Coaching on the Self Efficacy of Women of

Childbearing Age in the Prevention of Cervical Cancer with Visual

Inspection Acetic Acidate (IVA)

Khairun Nisa’

, Budi Santoso

and Esti Yunitasari

Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Keywords: Health Coaching, Self-efficacy, Woman of Childbearing Age, Cervical Cancer Prevention.

Abstract: Introductions: Cervical cancer is the second leading cause of death in women after breast cancer, Mortality

and morbidity rates increase continously, this phenomenon occurs because IVA examination is rarely found

in women of childbearing age. in women Low self-efficacy, lowers the commitment of society to prevent

cervical cancer With Visual Inspection Acetic Acidate. Method: This research was a quasi-experiment study

using pre and post control group design. A total of 70 responden from Puskesmas panaguan pamekasan

divided into 35 for the treatment group and 35 for the control group. The sampling method used was cluster

sampling based on the area. The dependent variable was self-efficacy and health coaching was the

independent variable. Data were taken with questionnaire and analysed by Wilcoxon signed rank test and

Mann Whitney U test with significance level 0.05. Result: The results showed the value of pre-test and post

test both in the health coaching group and the control group there is a significant difference this can be seen

from the known value of Asymp.Sig. (2-tailed) for the health coaching group of 0,000 and the control group

0.001. but when compared to post test between both groups it is known that the average difference is 49.14

for health coaching group and 21.86 for control group where there is difference of difference of mean value

equal to 27,28 points. By looking at the value of Asymp.Sig. of 0,000, where the value of Asymp.Sig. 0.000

<0.05, then there is a significant difference in self efficacy value between the health coaching group and the

control group. Conclusion: It can be concluded that health coaching is effective in improving women of

childbearing age (WUS)’s self-efficacy in the prevention of cervical cance

1 BACKGROUND

Cervical cancer is the second leading cause of death

in women after breast cancer, especially in

developing countries. (Denny and Prendiville, 2015)

states that cervical cancer is the second leading

cause of death in women after breast cancer.

Mortality and morbidity rates increase continously,

cases of cervical cancer are found to be more

advanced and cause death in women (WHO, 2007).

This phenomenon occurs because IVA examination

is rarely found in women of childbearing age. They

already came to health services in a state of illness

so late to be treated, consequently the mortality and

morbidity caused by cervical cancer increase

continously.

(Kolutek, Avci and Sevig, 2016) states that

women come to health services already in a state of

illness and in advanced stage so that the mortality

and morbidity caused by cervical cancer continues

cancer increase continously in the community.

Dealing with it, it is necessary to prevent cervical

cancer by performing IVA tests. According to the

study (Rogers et al., 2008) that the mortality rate in

women due to cervical cancer decreased

significantly after screening. IVA examination in

Indonesia is less than five percent (2.45%,) WHO

(2007). Estimated number of cervical cancer patients

in Indonesia in 2013 known East Java Province has

the largest cancer patients that is 98,692 cases

(Riskesda, 2013). Based on preliminary study in

Panaguwen Puskesmas work area, health promotion

about cervical cancer and IVA test have been done,

only few women come to do IVA test, carrying the

examination of IVA in 2017 as many as 5 from 341

women of childbearing age, and all found albuse

fluoride and recommended therapy according to

738

Nisa’, K., Santoso, B. and Yunitasari, E.

The Inﬂuence of Health Coaching on the Self Efﬁcacy of Women of Childbearing Age in the Prevention of Cervical Cancer with Visual Inspection Acetic Acidate (IVA).

DOI: 10.5220/0008332007380742

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 738-742

ISBN: 978-989-758-336-0

doctor's instructions. In the previous year nobody

did an IVA test. According to the study (Saleh et al.,

2013) stated that from 200 participants After the

IVA examination was found positive in 24/200

(12%) patients and Pap smears found 8 (4%). This

means that IVA examination is more sensitive to

early detection of cervical cancer and easier and

more affordable.

Highly effective IVA screening contributes to

lower mortality & morbidity associated with

malignancy of cervical cancer. In some large clinical

studies, IVA screening has shown clinical sensitivity

ranging from 41% - 92%, nearing the standard of

colposcopy. When compared with Pap-smear

examination, IVA increases detection by up to 30%.

Provision of health coaching in women of

childbearing age (WUS) is one method of education

not only providing cognitive aspects but also

psychomotoric and psychological aspects. Before

Health Coaching respondents do not understand how

to manage the disease, but after doing Health

coaching patients understand how to manage in

order to avoid recurrence (Crittenden, at al., 2017).

Health coaching is centered on the patient, where

the selection of activity objectives is determined by

the patient so that the patient is more involved, and

there is a learning process which can influence the

self efficacy that has a role in shaping the

commitment and behavior of cervical cancer

prevention. (Hermens et al., 2014) health coaching

Personal Health coaching Systems is a great way to

develop and maintain healthier behaviors. After

educating cervical cancer and health awareness all

respondents experienced increased knowledge of

cervical cancer screening and willing to participate

in screening (Lor., Al., 2014). Health promotion

provides support in relation to healthy behaviors,

and this leads to disease reduction and reduction of

unhealthy behaviors such as smoking, drinking

alcohol, fatigue, depression (West-Leuer, 2014). The

visual inspection of cervical cancer with visual

inspection acetate (IVA) in puskesmas panaguan

pamekasan.

2 METHOD

This research was a quasi-experiment study using

pre and post control group design. A total of 70

responden from Puskesmas panaguan pamekasan

divided into 35 for the treatment group and 35 for

the control group. The sampling method used was

cluster sampling based on the area. The dependent

variable was self-efficacy and health coaching was

the independent variable. Data were taken with

questionnaire and analysed by Wilcoxon signed rank

test and Mann Whitney U test with significance

level 0.05. The research design used in this research

is the type of quantitative research with Quasi

experimental design, that is the research that gives

treatment or intervention on the research subject

then the effect of the treatment is measured and

analyzed. The research templates used were pre-test

and post-test with control group desaign. This design

was used to compare the results of health coaching

interventions on women of childbearing age in the

group measured before and after intervention. In the

implementation of the research the treatment group

was given a health coaching on cervical cancer

prevention behavior with IVA method, while the

control group only followed the standard of

Puskesmas.

3 RESULT

The population in this study are women of

reproductive age who are married and who are in the

working area of Panaguwen Puskesmas.

Based on the above "Test Statistics" output, it is

known Asymp.Sig. (2-tailed) is worth 0,000. Since

the 0.000 value is less than <0.05, it can be

concluded that "Ha is accepted". This means that

there is a difference in self efficacy before the

Health Coaching action is given after being given

Health Coaching action on the treatment group. so it

can be concluded also that "there is influence Health

Coaching on self efficacy in treatment group. In

addition to knowing the magnitude of the

improvement of health coacing intervention results

Table 1: Different test before and after action of

Health Coacing on treatment group

Post test - Pre test Self-efficacy

group Health Coacing

-4.927

Asymp. Sig. (2-

tailed)

.000

a. Wilcoxon Signed Ranks Test

b. Based on negative ranks.

The Inﬂuence of Health Coaching on the Self Efﬁcacy of Women of Childbearing Age in the Prevention of Cervical Cancer with Visual

Inspection Acetic Acidate (IVA)

739

can be seen from the ftable 2.

Based on the value of Positive Ranks Pre Test

and Post Test of respondents experienced

improvement of self efficacy from Pre Test to Post

Test value, with the average increase is 16.0.

Based on the table 3 "Test Statistics" output, it is

known Asymp.Sig. (2-tailed) is worth 0,000. Since

the value of 0.001 is less than <0.05, it can be

concluded that "Ha is accepted". This means that

there are differences in self efficacy in the control

group.

In addition to knowing the magnitude of

effusions of pre and post results in the control group

can be seen from the table 4.

Based on the value of Positive Ranks Pre Test

and Post Test of respondents experienced

improvement of self efficacy from Pre Test to Post

Test value, with the average increase is 6.50.

Based on Mean Rank value post self efficacy test

in helath coacing group with control group table 5

known average difference of 49.14 for health

coaching group and 21.86 for control group which

happened difference difference of mean value equal

to 27,28, while to know whether the difference is

significant or not seen from nilia P (Asymp Sig. (2-

tailed) in the table 6:

Based on the above table, the value of

Asymp.Sig is known. of 0,000, due to the value of

Asymp.Sig. 0.000 <0,05, hence there is significant

difference of self efficacy value between treatment

group and control group. So it can be concluded that

there is influence Health Coacing on self efficacy in

women of childbearing age in doing cervical cancer

prevention with Visual Acetate Inspection method

(IVA).

4 DISCUSSION

Based on the result, the difference of self-efficacy

level of treatment group on pretest and posttest

through Wilcoxon test showed p value <0.05, beside

that in Mann Whitney test to see difference of

posttest result between treatment group and control

group got p value <0,05 which mean H1 accepted

that there is influence of health coaching to increase

self-efficacy of woman of child-bearing age in

prevention of cervical cancer in work area of

Puskesmas panaguan the 35 respondents in the

intervention group, there were 19 respondents who

did IVA examination, and the result of IVA

examination found that 6 respondents positive IVA

and 1 respondent found lumps on the uterine wall of

large and small size, 1 respondent whitish with

infection, and 4 respondents found regular whiteness

without the presence of infection, the rest is 7

respondents stated normal, for respondents who have

Table 2: Self efficacy of treatment group

Mean

Rank

Sum of

Ranks

Post test- Pre

test Self-

efficacy

group Health

Coacing

Negative

Ranks

.00

Positive

Ranks

16.00

496.00

Ties

Total

Table 3: Statistic result of treatment group

Post Tests - Pre-test Self-

efficacy Control Group

-3.464

Asymp. Sig. (2-tailed)

.001

Table 4: Pre and Post test on control group

Mean

Rank

Sum of

Ranks

Post Tests Self-

efficacy Control

Group

Pre-test Self-

efficacy Control

Group

Negative

Ranks

.00

Positive

Ranks

6.50

78.00

Ties

Total

Table 5: Statistic test of treatment and control group

Group

Mean

Rank

Sum of

Ranks

Post self-

efficacy

Health

Coacing

49.14

1720.00

Control

21.86

765.00

Total

Table 6: Mann-whitney test of treatment dan control

group

post self efficacy

Mann-Whitney U

135.000

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

740

problems on IVA examination directly followed up

by a specialist obstetric disease (Obgen), while 16

respondents who did not do IVA examination, 6 of

them were not allowed by her husbands, 5 of them at

the time of examination before the IVA test,

respondents was declared menstruation so they did

not do IVA test, and 5 others resigned at the time of

IVA examination, for fear of known their illness

Based on the Pender theory there are 2 basic

assumptions underlying health coaching: first the

health worker as part of the environment will affect

the person and the second is that each individual will

actively regulate his own behavior (Alligood, 2014).

The principle of health coaching is to help the

respondent self-regulate to change his behavior

where according to the Pender theory by changing

the affective status of a person will increase the self-

efficacy of the person (Gale, 2012). health coaching

contributes to care, patient planning and physician

activation as well as leadership development

(National Health Service, 2014). Individuals take

active and anticipatory action to eliminate or

mitigate harm by placing themselves directly on

existing circumstances and taking action in

accordance with what has been done by people who

have experienced before (Yunitasari, 2016)

Based on data analysis, the result of self-efficacy

is increasing. This is in accordance with the opinion

of Gale (2012) which states the goal of health

coaching is to improve self-efficacy. Mechanism of

the increase of self-efficacy during health coaching

begins with the determination of goals together with

researchers and respondents in implementing the

prevention of cervical cancer with IVA action

method.

5 CONCLUSIONS

Health coaching effectively improves self-efficacy

in the prevention of cervical cancer by IVA method

with realistic goal selection mechanisms as well as

lowering HIT and increasing HET which is a form

of affective response that determines the level of

one's self-efficacy.

Respondents are advised to always conduct a

clean and healthy lifestyle by routinely performing

the correct vulva hygiene and immediately replace

the pads at the time of menstruation and perform

IVA tests for early detection of cervical cancer.

Health coaching to momodify healthy lifestyles,

study results show that patient participation in health

management is necessary (Crittenden, Seibenhener

and Hamilton). Health Coaching is designed to

promote a healthy lifestyle and prevent T2DM,

whereby Health Coaching is provided with a Via

Cell Phone method provided to adolescents to

reduce the risk of T2DM, via via telephone health

coaching is given as a healthy lifestyle change

(Jefferson et al., 2011). Nurses are advised to use

health coaching as an alternative method in

implementing health promotion programs in the

prevention of cervical cancer as well as other cases.

The researcher is then expected to conduct research

with health coaching as well as to examine other

aspects of behavioral and affective behavioral

cognition domains which include benefit of action,

barrier, action, activity related affect, interpersonal

influence, and situational influence.

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