Cervical cancer can be controlled by providing screening and vaccination. Although rates for this female cancer are decreasing in developed countries, these low rates are not observed in the other countries. In Saudi Arabia, cervical cancer cases are increasing dramatically (from only 152 cases in 2014, to 241 cases in 2017). Lack of knowledge about cervical cancer prevention presumably contributes to the morbidity and mortality rate among Saudi women, as do religio-cultural beliefs about modesty, sexuality, and premarital virginity. Therefore, this study sought to describe how Saudi nurses’ knowledge and religio-cultural beliefs effected their intentions to promote cervical cancer prevention. The Theory of Reasoned Action, which posits that personal beliefs and subjective norms contribute to health behavior intentions, guided his study. A cross sectional, descriptive, mixed methods design using survey methods was employed. Data were collected in an urban hospital in Jeddah City, in the Kingdom of Saudi Arabia. All the female Saudi nurses who worked in this hospital were invited to participate in the study. The survey was comprised of quantitative scales and qualitative items that assessed the nurses’ knowledge and beliefs about cervical cancer screening and HPV vaccination, religious and cultural influences to seeking healthcare, intention to provide cervical

cancer prevention, as well as demographic items. Items and scales used were obtained from previous research or developed for this study; content validity indexing and “think aloud” processes supported the validity of the survey, and Cronbach’s alphas ranging from 0.52 to 0.84 for the scales lent support to the internal reliability of the instruments. The sample included 82 nurses (response rate of 98%). Results revealed low knowledge about cervical cancer prevention; the average number of knowledge items answered correctly was 44%. Linear regression results indicated that the more knowledge the nurse had, the greater her intention to provide care to prevent cervical cancer. A relationship between subjective norms and the nurse intentions, however, was not observed. Qualitative data, however, documented how religio-cultural beliefs would influence how they would care for a patient. These findings underscore the need for nursing education about cervical cancer prevention in Saudi Arabia.

LLU Discipline





School of Nursing

First Advisor

Elizabeth Taylor

Second Advisor

Barbara Anderson

Third Advisor

Fayette Truax

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Uterine Cervical Neoplasms; Early Detection of Cancer; Saudi Arabia - ethnology



Page Count

xiv, 134 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Nursing Commons