Publication Date



Open access

Degree Type


Degree Name

Doctor of Philosophy (PHD)


Nursing (Nursing)

Date of Defense


First Committee Member

Rosemary Hall - Committee Chair

Second Committee Member

JoNell Potter - Committee Member

Third Committee Member

Kandyce M. Richards - Committee Member

Fourth Committee Member

JoAnn Trybulski - Committee Member


Every year 33,000 women die of cervical cancer in Latin American and the Caribbean. Cervical cancer has been the leading cause of potential years of life lost in Chile. Identifying factors that increase Pap test adherence will be extremely useful for developing interventions to increase the use of the Pap test and to reduce the prevalence of cervical cancer. The purpose of this study was to develop and validate a questionnaire to examine women's beliefs about cervical cancer and the Pap test in Chilean women. The questionnaire, developed following the guidelines by Robert de Vellis, is based on the Health Belief Model. The content validity index was 0.93 after 10 Chilean expert's review. A cross-sectional design was implemented to validate the questionnaire. The sample included 333 women recruited from a women's health care center in Santiago, Chile. Exploratory factor analysis was used to evaluate validity and coefficient alpha to evaluate reliability. After six models were computed, the questionnaire was reduced from 53 to 28 items. The new questionnaire,"CPC-28" includes six domains: the barriers domain to take a Pap test considers problems related with a health care center, lack of knowledge and time, being afraid, and embarrassment; the cues to action domain considers cues from family, the health care professional, friend and media; the severity domain considers cervical cancer as a serious problem, the possibility to have a hysterectomy, radiation and chemotherapy, and to die from this disease; the susceptibility domain to take a Pap test considers symptoms, having children, and intercourse; the susceptibility to cervical cancer domain considers the risk to have the disease, age, and possibility to die; and the benefit domain includes to save a life, feel good, and to take care of health. An unexpected salient factor "need to have a Pap test" was found as part of the susceptibility domain. This finding is an important topic for future research. The CPC-28 questionnaire explained 49% of the total variance, and the reliability was .735. It was concluded that the CPC-28 questionnaire will have important implications on research, educative, and administrative role of nursing.


Nursing; Factor Analysis; Domains; Instruments