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Newton MV, Palanivelrajan VV. How "Breast Aware" are the Indian Women? A Study among the Women Visiting a Tertiary Care, Referral, and Teaching Hospital. Ann Afr Med 2024; 23:372-378. [PMID: 39034561 PMCID: PMC11364323 DOI: 10.4103/aam.aam_194_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/01/2024] [Indexed: 07/23/2024] Open
Abstract
INTRODUCTION "Who will educate us" lamented a School Principal after she took part in our study and education session. There is palpable low breast cancer (BC) literacy with rising incidence and disproportionate mortality rates. METHODOLOGY Breast Cancer Awareness Measure (BCAM) developed by Cancer Research UK was administered to 944 women. BCAM measures knowledge, age-related risk, and reported frequency of breast checking and other components. A woman is BC aware if she identified five or more nonlump symptoms, age-related risk, and reported breast checking once a week/month. At the end, each participant was given "Be Breast Aware" education; what/how to look for demonstrated on a model. RESULTS 2.8% health professionals. 3.1% BC survivors. 78.8% had lump knowledge and 55.3% had non-lump knowledge of BC, 10% had age-related risk knowledge. 24.3% check breasts once a week/month. 41.9% aware BC is common after 50 years. 14/944 (1.5%) had BC awareness. 59.9% had breast symptoms, but never consulted a doctor, 31.1% were embarrassed, and 29.4% were scared to consult. Nearly 43% heard of breast screening, 28.4% had mammography, 26.3% had ultrasound. About 44.1% knew family history risk. Those practicing breast checking looked for a size change (24.5%), nipple position (17.4%), discharge (22.1%), pain (32.5%), and lump (24.7%) in standing (17.8%), supine (8.5%) using finger pads (15.8%) fingertips (21.6%), using circular movements (16.4%), and pinching breast tissue (19.6%). CONCLUSION Health-care workers and BC survivors lack breast awareness which is alarming and indicates the need for BC awareness and post-BC treatment follow-up care education in these two groups and the general population. Some practice the wrong method (e.g., pinching tissue) of breast checking, which may lead to anxiety and unnecessary investigative costs. "Be Breast Aware" education based on the National Health Service 5-point plan given to 944 participants.
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Affiliation(s)
- Mario Victor Newton
- Department of General Surgery, St. John’s Medical College Hospital, Bengaluru, Karnataka, India
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Ma N, Chen L, Ding F, Liu X, Li J, Zhao Y. Identification of the health education targeted susceptible population of tuberculosis in Ningxia, Northwest China. Sci Rep 2024; 14:13071. [PMID: 38844544 PMCID: PMC11156889 DOI: 10.1038/s41598-024-63961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024] Open
Abstract
Knowledge, Attitude, and Practice (KAP) survey, as an effective measure tool, is of practical significance for identifying the susceptible population in high-incidence regions of tuberculosis (TB). We aim to identify the health education targeted susceptible population of TB and discuss the acting pathway of KAP in Ningxia. A multistage random sampling method was used to conduct a face-to-face questionnaire survey for residents. The latent class analysis (LCA) model was used to classify susceptible populations of TB, and the structural equation modeling (SEM) model was also employed to investigate the interaction mechanisms of KAP (mediation analysis). We further applied the ordered logistic regression model to explore the associated factors. A total of 973 residents were enrolled, 70.6% were male, aged from 16 to 89. The LCA analysis demonstrated that 3 categories of susceptible populations of TB ("overall good", "positive attitude" and "overall poor") have optimal goodness of fit (BIC = 7889.5, Entropy = 0.923). SEM model indicated that the attitude plays a significant mediation effect from knowledge to practice toward TB (an indirect effect of 0.038, and a direct effect of 0.138). The ordered logistic regression results found that age, sex, marital status, education level, occupation, family income, self-perceived health status, having a family member or friend with TB, and knowing the DOTS strategy were significantly associated with classifications of KAP level towards TB. Based on the LCA model, we accurately classified the susceptible population of TB into 3 groups with different degrees of KAP. We found that TB attitude plays a mediating role between knowledge and practice. Therefore, we should pay more attention and carry out targeted health education in the community to these populations with overall poor KAP towards TB, and develop effective strategies and measures to realize the End TB Plan.
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Affiliation(s)
- Ning Ma
- School of Public Health, Ningxia Medical University, Ningxia, China
| | - Linlin Chen
- School of Public Health, Ningxia Medical University, Ningxia, China
| | - Fan Ding
- School of Public Health, Ningxia Medical University, Ningxia, China
| | - Xianglong Liu
- School of Public Health, Ningxia Medical University, Ningxia, China
| | - Jiangping Li
- School of Public Health, Ningxia Medical University, Ningxia, China
| | - Yu Zhao
- School of Public Health, Ningxia Medical University, Ningxia, China.
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Papasozomenou P, Eskitzis P, Panteris E, Gerede A, Patsiatzi A, Zafrakas M. Transcultural Adaptation of the Breast Cancer Awareness Measure in a Rural Border Area of Greece. Cureus 2024; 16:e61396. [PMID: 38953086 PMCID: PMC11214931 DOI: 10.7759/cureus.61396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Breast cancer awareness is a concept suggesting that awareness of signs and symptoms and early seeking of medical advice may decrease mortality, especially in limited resource settings. METHODS A modified questionnaire based on the breast cancer awareness measure (BCAM) by Cancer Research UK was translated into Greek and used for the first time. Participants were women residing in a rural border area in Greece. For statistical analysis the χ2 goodness-of-fit and Cramer's V test for categorical comparisons were used and Cronbach's alpha for reliability analysis. RESULTS In total, 110 women filled out and returned the questionnaire. Respondents appeared to be inappropriately informed regarding the less common warning signs of breast cancer, the most common age of breast cancer occurrence, the national screening program, and the less important risk factors of breast cancer. On the other hand, most women appeared to be confident in recognizing breast changes and seeking medical advice if needed. CONCLUSIONS The translated modified BCAM tool can be used to evaluate breast cancer awareness in Greek women. Future campaigns developed by policymakers should focus on improving breast cancer awareness, especially in socioeconomically deprived areas.
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Affiliation(s)
- Panayiota Papasozomenou
- Department of Midwifery, School of Health Science, International Hellenic University, Thessaloniki, GRC
| | - Panagiotis Eskitzis
- Department of Midwifery, School of Health Science, University of Western Macedonia, Ptolemais, GRC
| | - Eleftherios Panteris
- Department of Midwifery, School of Health Science, International Hellenic University, Thessaloniki, GRC
| | - Angeliki Gerede
- Department of Obstetrics and Gynecology, Medical School, University of Thrace, Alexandroupolis, GRC
| | - Anastasia Patsiatzi
- Department of Midwifery, School of Health Science, International Hellenic University, Thessaloniki, GRC
| | - Menelaos Zafrakas
- Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, GRC
- Department of Midwifery, School of Health Science, International Hellenic University, Thessaloniki, GRC
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Zhu L, Zhou Q, Huang Z, Yang Y, Yang Y, Du Y, Zhao Y, Yu X, Li T, Chen W. Factors Influencing Breast Cancer Awareness in Rural Southwest China: A Cross-Sectional Study. Int J Womens Health 2024; 16:509-518. [PMID: 38533523 PMCID: PMC10964776 DOI: 10.2147/ijwh.s453857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to explore the current knowledge level of breast cancer among rural women in Southwest China and analyze the influencing factors of breast cancer cognition. Methods From May to November 2022, 1468 rural women were invited to participate in this study. Demographic information and the Chinese version of the Breast Cancer Awareness Measure (C-BCAM) were collected through one-on-one investigations. The data were analyzed using descriptive statistics, chi-square tests, and multiple regression analysis in SPSS 26.0. Results The study included a total of 1468 rural women with a median age of 54.0 (IQR, 47.0, 60.0).The average score of breast cancer in the study population was 73.0 (IQR, 66.0, 82.0). Among women in Southwest China, the awareness rates of knowledge on breast cancer symptoms, barriers to seeking medical help, and risk factors were 68.8%, 98.4%, and 62.1%, respectively. The awareness rate was found to increase with higher education levels (P<0.001) and decrease with increasing age (P<0.001). Multivariate logistic regression analysis identified three variables that might influence breast cancer awareness: education level, contraceptive measures, and history of breast disease (all P<0.05). Specifically, history of breast disease (Odds ratio (OR) = 1.907, 95% CI = 1.128 ~ 3.223), middle school education (OR = 2.155, 95% CI = 1.585 ~ 2.928), and junior college education and above (OR = 5.536, 95% CI = 1.898 ~ 16.148) were positive factors for women's breast cancer awareness. Conversely, the use of intrauterine devices (OR = 0.523, 95% CI = 0.384 ~ 0.712) was found to be a negative factor for women's breast cancer awareness. Conclusion This study highlights the insufficient awareness of breast cancer among women in rural area of Southwest China. It emphasizes the necessity of health education to improve female breast cancer awareness.
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Affiliation(s)
- Lingling Zhu
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Qiang Zhou
- College of Public Health, Chengdu Medical College, Chengdu, Sichuan, 610500, People’s Republic of China
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Ziyue Huang
- Mianyang Maternal and Child Health Care Hospital, Mianyang, Sichuan, 621000, People’s Republic of China
| | - Yuan Yang
- School of Public Health, Xiamen University, Xiamen, Fujian, 361102, People’s Republic of China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
| | - Ying Yang
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yao Du
- Yanting County Maternal and Child Health Hospital, Mianyang, Sichuan, 621600, People’s Republic of China
| | - Yuqian Zhao
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Xiaoping Yu
- School of Preclinical Medicine, Chengdu University, Chengdu, Sichuan, 610106, People’s Republic of China
| | - Tingyuan Li
- Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, 610041, People’s Republic of China
| | - Wen Chen
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People’s Republic of China
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Xu K, Liang C, Zhao Y, Zhang F, Zhang C, Zhang Y, Zhang Y, Jiang Z. Psychometric evaluation of the Chinese version of the Scale of Effects of Social Media on Eating Behaviour and research of its influencing factors. BMC Public Health 2024; 24:508. [PMID: 38368327 PMCID: PMC10874064 DOI: 10.1186/s12889-024-17923-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/30/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Social media has become an indispensable part of contemporary young people's lives, and the influence of social media on college students' eating and other health-related behaviors has become increasingly prominent. However, there is no assessment tool to determine the effects of social media on Chinese college students' eating behavior. This study aims to translate the Scale of Effects of Social Media on Eating Behaviour (SESMEB) into Chinese. Its applicability to Chinese college students was examined through reliability and validity indexes, and the influencing factors of SESMEB were explored. METHODS The questionnaire survey included 2374 Chinese college students. The Brislin translation model was used to translate the original scale into Chinese. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test the construct validity of the scale, and the content validity of the scale was assessed through the content validity index. The internal consistency of the scale was assessed by calculating Cronbach's alpha coefficient, McDonald's Omega coefficient, split-half reliability, and test-retest reliability. Multiple stepwise linear regression analysis was performed to identify potential influences on the effects of social media on eating behavior. RESULTS EFA supported the one-factor structure, and the factor loadings of each item on this dimension were higher than 0.40. CFA showed good model fitness indexes. The content validity index of the scale was 0.94. The Cronbach's alpha coefficient and McDonald's Omega coefficient for the scale were 0.964, the split-half reliability coefficient was 0.953, and the test-retest reliability was 0.849. Gender, education, major, frequency of social media use, online sexual objectification experiences, fear of negative evaluations, and physical appearance perfectionism explained 73.8% of the variance in the effects of social media on eating behavior. CONCLUSIONS The Chinese version of the SESMEB has good psychometric properties and is a valid measurement tool for assessing the effects of social media on college students' eating behavior. Subjects who were female, highly educated, non-medical, had frequent social media use, online sexual objectification experiences, fear of negative evaluations, and physical appearance perfectionism used social media to have a higher impact on eating behavior.
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Affiliation(s)
- Kaiyan Xu
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Chunguang Liang
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China.
| | - Ying Zhao
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Fan Zhang
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Chunyan Zhang
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Yanhong Zhang
- Shenyang Jianzhu University Hospital, No. 25, Hunnan Middle Road, Hunnan District, Shenyang, 110168, P.R. China
| | - Yefan Zhang
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
| | - Zhaoquan Jiang
- School of Nursing, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, P.R. China
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Lounis M, Belkessa S, Abdelhadi S, Bencherit D, Samara KA, Barqawi HJ. Breast cancer knowledge and practices amongst women in Algeria. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04786-z. [PMID: 37147506 DOI: 10.1007/s00432-023-04786-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/15/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE The present study aims at investigating how Algerian women feel about Breast Cancer (BC) and Breast Self-Examination (BSE) in terms of knowledge and attitude and to determine the factors associated with performing BSE and its reluctance. METHODS We carried out a cross-sectional survey between October 14, 2021 and November 14, 2022, targeting Algerian females aged more than 18 years and living in the country using a self-administered questionnaire. RESULTS A total of 436 participants were involved in this study among which 41.28% were aged between 21 and 30 years and 34.86% were aged between 31 and 40 years. The average level of correct responses with regard to knowledge about BC was estimated at 51.31%, whereas it was 32.93% concerning knowledge about BC risk factors. Family history was the less reported incriminating factor for developing BC among the asked women (7.34%). Concerning alarming signs of BC, the current study revealed that Algerian women were less knowledgeable about breast dimpling-puckering (44.27%), breast inward traction (50.23%), breast redness (54.13%), and nipple position change (54.13%). In terms of belief in the utility of BSE in the early detection of BC, almost all the participants (97.98%) were convinced of its utility, whereas 96.33% of them showed an interest in learning more about it. In what concerns the early screening tests, approximately, four-fifth of the participant (77.52%) heard about them, while 94.72% believed that its early detection could reduce the disease's severity and mortality. CONCLUSION These findings revealed an insufficient level of knowledge concerning BC, especially in regard to its risk factors and some alarming signs as well as a lack of knowledge about BSE and other BC screening tests; hence the necessity of awareness campaigns about this disease that should target categories with the lowest level of knowledge.
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Affiliation(s)
- Mohamed Lounis
- Department of Agro-Veterinary Sciences, Faculty of Natural and Life Sciences, University of Ziane Achour, BP 3117, Road of Moudjbara, 17000, Djelfa, Algeria.
- Laboratoire d'Exploration et Valorisation des Écosystèmes Steppiques (LEVES), Faculty of Natural and Life Sciences, University of Ziane Achour, BP 3117, Road of Moudjbara, 17000, Djelfa, Algeria.
| | - Salem Belkessa
- Department of Biology, Faculty of Natural and Life Sciences, University of Ziane Achour, 17000, Djelfa, Algeria
| | - Samir Abdelhadi
- Department of Mathematics, Faculty of Exact Sciences, Frères Mentouri University, 25000, Constantine, Algeria
| | - Djihad Bencherit
- Laboratoire d'Exploration et Valorisation des Écosystèmes Steppiques (LEVES), Faculty of Natural and Life Sciences, University of Ziane Achour, BP 3117, Road of Moudjbara, 17000, Djelfa, Algeria
- Department of Biology, Faculty of Natural and Life Sciences, University of Ziane Achour, 17000, Djelfa, Algeria
| | | | - Hiba Jawdat Barqawi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Liu Y, Tian H, Chen X, Jia F, Li R, Sun Y, Chen L, Zhu J, Jiang D, Zhuo C. Validity and reliability of a Chinese version of the Bergen Work Addiction Scale. Front Psychol 2023; 14:1029846. [PMID: 37205064 PMCID: PMC10185827 DOI: 10.3389/fpsyg.2023.1029846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/06/2023] [Indexed: 05/21/2023] Open
Abstract
Background Work addiction (WA), which can impair personal relationships, engagement in recreational activities, and/or health, is a behavioral addiction. A tool for the early detection of WA in China is needed. Objective The aim of this study was to develop and determine the validity and reliability of a Chinese version of the Bergen Work Addiction Scale (C-BWAS). Methods Two hundred social workers who provided post-discharge services for adolescents with non-suicidal self-injury (NSSI) were enrolled in this study. The construct validity of the C-BWAS was assessed by confirmatory factor analysis (CFA). Criterion validity was assessed by conducting Pearson correlation analyses of C-CWAS scores with Hamilton Depression Scale (HAM-D) and Hamilton Anxiety Scale (HAM-A) scores. Cronbach's α and the intra-class correlation coefficient (ICC) were used to evaluate the reliability of the C-BWAS. Results CFA confirmed a one-dimensional structure of the C-BWAS with good construct validity indices [comparative fit index (CFI) = 0.964, Tucker-Lewis index (TLI) = 0.951, root-mean-square error of approximation (RMSEA) = 0.079, and minimum discrepancy Ĉ/degrees of freedom (Cmin/DF) = 0.362]. The standardized regression weights ranged from 0.523 to 0.753. All C-BWAS items loaded on one major factor (loading weights, 0.646-0.943). Coefficients of correlation between C-BWAS scores and HAM-D and HAM-A scores were 0.889 and 0.933, respectively. The Cronbach's α coefficient and ICC for the instrument was 0.837 and 0.905, respectively. Conclusion The presently developed C-BWAS showed very good reliability and acceptably validity. It can be employed as a useful tool for assessing WA severity in social workers who provide post-discharge services for adolescents with NSSI.
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Affiliation(s)
- Yuanyuan Liu
- Department of Psychosomatic Medicine, Tianjin Chest Hospital, Tianjin, China
- Yuanyuan Liu,
| | - Hongjun Tian
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Hongjun Tian,
| | - Xinying Chen
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Feng Jia
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Yun Sun
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Langlang Chen
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
- *Correspondence: Deguo Jiang,
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
- Chuanjun Zhuo,
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Kizilkaya MC, Kilic SS, Bozkurt MA, Sibic O, Ohri N, Faggen M, Warren L, Wong J, Punglia R, Bellon J, Haffty B, Sayan M. Breast cancer awareness among Afghan refugee women in Turkey. EClinicalMedicine 2022; 49:101459. [PMID: 35747185 PMCID: PMC9168491 DOI: 10.1016/j.eclinm.2022.101459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 04/22/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Background Refugees and asylum-seekers have lower levels of cancer awareness and this contributes to low rates of screening and more advanced cancers at diagnosis, compared to non-refugee populations, due largely to reduced access to medical information and care. The global Afghan refugee population is rapidly increasing with the ongoing Afghan political crisis. The present study investigates breast cancer (BC) awareness among Afghan refugee women. METHODS A cross-sectional survey of Afghan refugee women residing in Turkey was performed in September 2021. A validated BC patient awareness assessment, the Breast Cancer Awareness Measure (BCAM), was used to assess participants' knowledge of seven domains of BC: symptoms, self-examination, ability to notice breast changes, age-related risk of BC, urgency of addressing changes in the breast, BC risk factors, and BC screening. BCAM was translated into patients' native language and administered verbally by a physician with the assistance of an official interpreter. Routine statistical methods were employed for data analysis. FINDINGS A total of 430 patients were recruited to the study. The response rate was 97·7% (420 patients). The median participant age was 35 years (range: 18 to 68 years). The majority of participants (84%) had no formal education. Most participants (96%) were married, and most (95%) were not employed. Awareness of warning signs of BC was low: only seven to 18% of participants recognized 11 common warning signs of BC. Participant use of breast self-exam (BSE) was low, with 82% of participants stating they rarely or never complete BSE. Zero of 420 patients reported ever seeing a physician for a change in their breasts. Awareness of risk factors for BC was also low: only 15% of participants recognized increasing age as a risk factor for BC, and other risk factors were only recognized by four to 39% of participants. INTERPRETATION BC awareness among Afghan refugee women is critically low. There is an urgent need to target this population for practical interventions to increase BC awareness, in addition to screening and earlier diagnosis. Evidence-based interventions include educational sessions in patients' native language and use of BSE and clinical breast examination for screening. FUNDING American Society for Radiation Oncology (ASTRO) - Association of Residents in Radiation Oncology (ARRO) Global Health Scholar Grant, Dana-Farber Cancer Institute Jay Harris Junior Faculty Research Grant.
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Affiliation(s)
- Mehmet Celal Kizilkaya
- Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Mehmet Abdussamet Bozkurt
- Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Osman Sibic
- Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nisha Ohri
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Meredith Faggen
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
| | - Laura Warren
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
| | - Julia Wong
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
| | - Rinaa Punglia
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
| | - Jennifer Bellon
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
| | - Bruce Haffty
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Mutlay Sayan
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street. ASB1 - L2, Boston, MA 02115, United States
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Haghighat S, Omidi Z, Koosha M, Nazeri N, Khosravi N, Zolfaghari S. Status of breast cancer screening strategies and indicators in Iran: A scoping review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:21. [PMID: 35419063 PMCID: PMC8995307 DOI: 10.4103/jrms.jrms_1390_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 11/04/2022]
Abstract
Background: Materials and Methods: Results: Conclusion:
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Vafaei Z, Najafian J, Shekarchizadeh M, Mostafavi S, Darakhshandeh A, Khosravifarsani M, Ashrafi F, Sharifi M, Mohammadifard N, Emami MH, Haghjooy-Javanmard S, Sarrafzadegan N. Validation of a newly developed questionnaire regarding clinical history in patients with breast and colorectal cancers. ARYA ATHEROSCLEROSIS 2021; 17:1-10. [PMID: 35685447 PMCID: PMC9145839 DOI: 10.22122/arya.v17i0.2212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 05/15/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Understanding the close interaction between the specialties of cardiology and oncology is necessary for early detection of cardiovascular disease (CVD) events in cancer patients. For the risk assessment of CVD in Breast and Colorectal Cancers (CIBC) study, in the current study we aimed to validate a questionnaire for the assessment of clinical history in patients with breast cancer and colorectal cancer (CRC). METHODS We determined the content validity of the questionnaire using the 2 indexes of content validity ratio (CVR) and content validity index (CVI) to examine the specificity, simplicity, clarity, and transparency of the items. Content validity assessment was performed through a panel of experts including 2 oncologists, 5 cardiologists, 2 general practitioners, and 1 epidemiologist. The reliability of the questionnaire was estimated using Cronbach's alpha coefficient in 50 patients. Intraclass correlation coefficient (ICC) was used to examine the reproducibility of the questionnaire during 1 week. RESULTS The CRC and breast cancer questionnaire were designed with 16 and 32 questions, respectively. To obtain acceptable CVR, 5 and 11 questions were removed from the CRC and breast cancer questionnaires, respectively. Cronbach's alpha was 0.70 in the breast cancer questionnaire and 0.94 in the CRC questionnaire. All questions had a CVI of higher than 80%. The ICC in the breast cancer questionnaire ranged between 0.71 and 0.96 and in CRC questionnaire ranged between 0.78 and 0.98. CONCLUSION The validity and reliability of our newly developed questionnaire was desirable. The reliability of the breast cancer questions was acceptable and that of the CRC questions was excellent. Thus, thus questionnaire can be used in this group of patients regardless of whether the goal is cardiac care or not.
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Affiliation(s)
- Zamaneh Vafaei
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Najafian
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masood Shekarchizadeh
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh Mostafavi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Darakhshandeh
- Department of Medical Oncology-Hematology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Farzaneh Ashrafi
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Sharifi
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Seyyed AlShohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Emami
- Poursina Hakim Digestive Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy-Javanmard
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Nizal Sarrafzadegan; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran;
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Ismail H, Shibani M, Zahrawi HW, Slitin AF, Alzabibi MA, Mohsen F, Armashi H, Bakr A, Turkmani K, Sawaf B. Knowledge of breast cancer among medical students in Syrian Private University, Syria: a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:251. [PMID: 33933051 PMCID: PMC8088684 DOI: 10.1186/s12909-021-02673-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 04/15/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer among women and the second leading cause of cancer death globally. Since early diagnosis is crucial to reducing mortality, high levels of knowledge regarding general information, risk factors, and symptoms are required among healthcare professionals to deliver breast cancer care. This study aimed to determine Syrian medical students' knowledge about breast cancer in the fields of general knowledge, common clinical features, and risk factors. METHODS This cross-sectional study was conducted at the Syrian Private University in October 2019 (Breast Cancer Awareness Month), Damascus, during the Syrian war crisis. Data were collected through self-administered surveys and analyzed using the Statistical Package for Social Sciences version 25.0 (SPSS Inc., United States). The chi-square test was applied to assess the relationship between the level of knowledge and gender. One way analysis of variance was performed to assess the overall differences in mean knowledge score by study year, GPA, mother's education, and source of information. Unpaired Student's T-test was used to analyze the differences in mean knowledge scores (continuous variable) based on smoking status and alcohol consumption. RESULTS Of 320 students, 301 completed the questionnaire (response rate = 94.0%), of which 179(59.5%) were males. The study revealed above-average knowledge scores (total mean = 68.4%) regarding breast cancer, general information (71.9%), common clinical features (71.6%), and risk factors (71.6%). Clinical students (4th, 5th, and 6th years) scored higher compared with pre-clinical students (1st, 2nd, and 3rd years). CONCLUSION This study showed above-average knowledge scores regarding breast cancer. More efforts to correct misinformation, through reassessing the university curriculum and promoting awareness about breast cancer are required.
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Affiliation(s)
- Hlma Ismail
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Mosa Shibani
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Hanaa Wael Zahrawi
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Ali Fouad Slitin
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Mhd Amin Alzabibi
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic.
| | - Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Humam Armashi
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
| | - Aliaa Bakr
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
- Department of Internal Medicine, Oncology Medicine, Damascus University, Damascus, Syria
| | - Khaled Turkmani
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
- AL Kalamoon General Hospital, Ministry of Health, Damascus, Syria
| | - Bisher Sawaf
- Faculty of Medicine, Syrian Private University, Mazzeh Street, P.O. Box 36822, Damascus, Syrian Arab Republic
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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12
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Hajian-Tilaki K, Nikpour M. Accuracy of self-perceived risk perception of breast cancer development in Iranian women. BMC WOMENS HEALTH 2021; 21:93. [PMID: 33663481 PMCID: PMC7934235 DOI: 10.1186/s12905-021-01238-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 02/22/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The accuracy of subjective risk perception is a matter of concern in breast cancer development. The objective of this study was to evaluate the accuracy of self-perceived risk assessment of breast cancer development and compared to actual risk in Iranian women. METHODS The demographic, clinical, and reproductive characteristics of 800 women aged 35-85 years were collected with an in-person interview. The self-perceived risk and the actual risk were assessed using the visual analog scale (VAS) and he Gail model respectively. Gail's cutoff of 1.66% risk was used to categorize the estimated 5-year actual risk as low/average risk (< 1.66%) and high risk (≥ 1.66). In low/average risk, if the self-perceived risk > actual risk, then individuals were considered as overestimating. Similarly, in high-risk women, if the perceived risk < actual risk, then, the subjects were labeled as under-estimate; otherwise, it was labeled as accurate. The Kappa statistics were used to determine the agreement between self-perceived risk and actual risk. ROC analysis was applied to determine the accuracy of self-perceived risk in the prediction of actual risk. RESULTS The perceived risk was significantly higher than actual risk (p = 0.001, 0.01 for 5-year and lifetime risk respectively). Both in low and high-risk groups about half of the women over-estimate and underestimate the risk by subjective risk perception. For a 5-year risk assessment, there was no agreement between perceived risk and actual risk (Kappa = 0.00, p = 0.98) but a very low agreement between them in lifetime risk assessment (Kappa = 0.09, p = 0.005). The performance of accuracy of risk perception versus actual risk was very low (AUC = 0.53, 95% CI 0.44-0.61 and AUC = 0.58, 95% CI 0.54-0.62 for the 5-year risk and lifetime risk respectively). CONCLUSION The clinical performance of risk perception based on VAS is very poor. Thus, the efforts of the public health education program should focus on the correct perception of breast cancer risk among Iranian women.
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Affiliation(s)
- Karimollah Hajian-Tilaki
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran.,Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Nikpour
- Non-Communicable Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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13
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Firouzbakht M, Hajian-Tilaki K, Bakhtiari A. Comparison of competitive cognitive models in explanation of women breast cancer screening behaviours using structural equation modelling: Health belief model and theory of reasoned action. Eur J Cancer Care (Engl) 2020; 30:e13328. [PMID: 32909679 DOI: 10.1111/ecc.13328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 01/22/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The efficacy of the theory of reasoned action (TRA), compared with the health belief model (HBM), has not been fully elucidated in screening practices. METHODS This population-based cross-sectional study was conducted with samples of 500 women aged 35-85 years, in the north of Iran. The data of demographic characteristics, awareness, health belief, subjective norms and screening behaviours were collected using standard instruments. Structural equation modelling (SEM) was applied to estimate the pathways of regression coefficients. RESULTS The model that incorporated the health belief and the standardised coefficient of the knowledge scores influenced significantly on the health belief perception (beta = 0.375), and consequently, the health belief directly affected screening behaviours (beta = 0.73). In contrast, In TRA model, while the direct effect of knowledge on intention was negligible it has a greater indirect effect by mediating health belief and subjective norms (indirect beta = 0.35) on behaviour intention. A high coefficient of intention was observed by subjective norms (beta = 0.626), and the intention has a great positive effect on screening behaviour (beta = 0.601). All fitting indexes were quietly improved in the TRA model as compared with HBM. CONCLUSION Thus, the unifying structure of knowledge, health belief, subjective norms and intention improves the predictor power in breast cancer screening behaviours.
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Affiliation(s)
- Mojgan Firouzbakht
- Department of nursing- midwifery, Babol Branch, Islamic Azad University, Babol, Iran
| | - Karimollah Hajian-Tilaki
- Department of Biostatistics and Epidemiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Bakhtiari
- Department of Midwifery, School of Medicine, Babol University of Medical Sciences, Babol, Iran
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Omar A, Bakr A, Ibrahim N. Female medical students' awareness, attitudes, and knowledge about early detection of breast cancer in Syrian Private University, Syria. Heliyon 2020; 6:e03819. [PMID: 32368654 PMCID: PMC7184173 DOI: 10.1016/j.heliyon.2020.e03819] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/30/2019] [Accepted: 04/17/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. The study aims to determine the community awareness levels in our country and extrapolate knowledge and awareness about the methods of early detection. METHODS It was performed as cross-sectional study in Syrian Private University in Damascus, Syria from January to March 2019. The population included female students of all years in medical faculties: medicine, pharmacy and dentistry collages. Data collection have been done by breast cancer awareness measure (BCAM) questionnaire. RESULTS The total participants were 407 divided into three faculties. The average knowledge rate was (57.5%). (70 %) of participants were not familiar with mammography. It is a good result that (86.7 %) acquainted about self-examination and (94.8%) believe that it is very important. But it is obvious that the practical side is poor, there were (32.7%) of students who apply BSE. CONCLUSION This study showed a lack of awareness among medical students. Perhaps the most important reason is the lack of awareness programs that must include all strata of society, especially students of medical colleges and doctors for their important role in spreading awareness to avoid this danger that surrounds our ladies.
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Affiliation(s)
- Abdullah Omar
- Syrian Private University, Faculty of Medicine, Damascus, Syria
| | - Aliaa Bakr
- Syrian Private University, Faculty of Medicine, Damascus, Syria
- Internal Medicine Department, Oncology Medicine, Damascus University, Damascus, Syria
| | - Nazir Ibrahim
- Syrian Private University, Faculty of Medicine, Damascus, Syria
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15
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Liu N, Li P, Wang J, Chen DD, Sun WJ, Guo PP, Zhang XH, Zhang W. Psychometric properties of the Breast Cancer Awareness Measurement among Chinese women: a cross-sectional study. BMJ Open 2020; 10:e035911. [PMID: 32156770 PMCID: PMC7064072 DOI: 10.1136/bmjopen-2019-035911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To perform the cross-cultural adaption of the Breast Cancer Awareness Measurement (BCAM) and to test its psychometric properties among Chinese women. DESIGN This is a cross-sectional study. SETTINGS This study was conducted in communities, schools and institutions in Changchun, Jilin Province, China. PARTICIPANTS A total of 328 women voluntarily participated in and completed the Chinese version of the BCAM (C-BCAM), resulting in an effective response rate of 91.1%. PRIMARY AND SECONDARY OUTCOME MEASURES Psychometric properties, including item analysis (the extreme group comparison and item-total correlations), content validity (item-level content validity index (I-CVI) and scale-level content validity index (S-CVI)), construct validity (exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)) and internal consistency (Cronbach's α and test-retest reliability), were measured. RESULTS The C-BCAM has excellent internal consistency (Cronbach's α=0.90), with alpha coefficients of 0.88, 0.84 and 0.94 for its three domains. The test-retest reliability coefficient was 0.72. The I-CVI ranged from 0.86 to 1.00, and the S-CVI was 0.92. CFA showed that the three-factor model explained 51.56% of the total variance, with a good model fit (likelihood ratio χ2/df=1.86, incremental fit index=0.94, comparative fit index=0.94, goodness-of-fit index=0.84, adjusted goodness-of-fit index=0.80, standardised root mean square error of approximation=0.06 and root mean square residual=0.05). CONCLUSIONS The C-BCAM has satisfactory validity and reliability and is a culturally appropriate and reliable tool for evaluating breast cancer awareness among Chinese women. This reliable instrument can help researchers and health professionals evaluate women's knowledge about the symptoms and risk factors of breast cancer and identify their barriers to seeking medical help. It also helps healthcare providers identify women with poor breast cancer awareness and encourage them to perform screening practice.
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Affiliation(s)
- Na Liu
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Ping Li
- Developmental Pediatrics, Jilin University Second Hospital, Changchun, Jilin, China
| | - Jie Wang
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Dan-Dan Chen
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Wei-Jia Sun
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Ping-Ping Guo
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Xue-Hui Zhang
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
| | - Wei Zhang
- Nursing School of Jilin University, Jilin University, Changchun, Jilin, China
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Htay MNN, Donnelly M, Schliemann D, Loh SY, Dahlui M, Tamin NSBI, Somasundaram S, Su TT. Translation and Validation of the Breast Cancer Awareness Measurement Tool in Malaysia (B-CAM-M). Asian Pac J Cancer Prev 2020; 21:217-223. [PMID: 31983187 PMCID: PMC7294017 DOI: 10.31557/apjcp.2020.21.1.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer among women in Malaysia, and the incidence of 31.1 per 100,000 population is comparatively higher than other Southeast Asian countries. Diagnosis tends to occur at later stages which may be due, partly, to inadequate knowledge about warning signs and symptoms. Therefore, this study investigated the validity and reliability of a UK-developed measure in the context of assessing women's awareness of breast cancer in Malaysia. AIMS This study aimed to translate, adapt and validate the internationally recognised Breast Cancer Awareness Measure (B-CAM) into the Malay language. METHODS The original B-CAM (Cancer Research UK) was forward and backward translated and content validation was ascertained. Face validity (n=30), test-retest reliability (n=50) and the internal consistency of the B-CAM-M (M for Malay language) were assessed in a community sample of adults (n=251) in 2018. RESULTS The translated B-CAM-M was validated by an expert panel. The Item-Content Validity Index ranged from .83 to 1.00. The results from the survey (n=251) indicated that the B-CAM-M was well received by Malay-speaking women across the main ethnic groups (85 Malay, 84 Chinese and 82 Indian adults). Cronbach alpha scores for the knowledge about breast cancer symptoms (0.83) and the barriers to healthcare seeking items (0.75) were high. Test-retest reliability (separated by 2-week-interval) with 50 randomly selected participants from the community survey produced intra-class correlations ranging from 0.39 to 0.69. CONCLUSION The Malay-version, the B-CAM-M, is a culturally acceptable, valid and reliable assessment tool with which to measure breast cancer awareness among Malay-speaking women.
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Affiliation(s)
- Mila Nu Nu Htay
- Department of Social and Preventive Medicine,
- Department of Rehabilitation Medicine, University of Malaya,
| | | | | | - Siew Yim Loh
- Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka,
| | - Maznah Dahlui
- Department of Social and Preventive Medicine,
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Bandar Sunway Malaysia,
| | | | | | - Tin Tin Su
- Department of Social and Preventive Medicine,
- Ministry of Health, Putrajaya, Malaysia.
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Heidari Z, Feizi A. Transcultural adaptation and validation of the Persian version of the breast cancer awareness measure (BCAM) questionnaire. Cancer Med 2018; 7:5237-5251. [PMID: 30152046 PMCID: PMC6198204 DOI: 10.1002/cam4.1740] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/OBJECTIVE Enhancing awareness level about breast cancer is a pivotal strategy for reducing breast cancer burden. There is no fully validated Persian instrument for evaluating breast cancer awareness. This study aimed at investigating the validity and reliability of the Persian version of the Breast Cancer Awareness Measure (BCAM) questionnaire. METHODS This methodological cross-sectional study was conducted among 1078 Persian language women (including 965 general women and 113 medical/clinical experts), which selected from different parts of Isfahan city using multistage cluster random sampling method. Translation of BCAM questionnaire was performed using forward-backward method. Internal consistency was evaluated through Cronbach's α and test-retest reliability using unweighted kappa statistic and intraclass correlation (ICC) coefficient. Construct validity was investigated using both exploratory and confirmatory factor analyses as well as Latent class analysis (LCA), and discriminant validity using ROC curve. Convergent validity was assessed using phi and eta correlation coefficients. Ceiling and floor effects, SE of measurement (SEM), and smallest detectable change (SDC) were also determined. RESULTS Persian version of BCAM showed excellent test-retest reliability (ICC = 0.841) and internal consistency (Cronbach's alpha = 0.882). Most of the computed kappa coefficients were in the range moderate to very good (0.47-0.81). Medical/clinical experts had higher levels of breast cancer awareness than general women, indicating good discriminant validity (Area under the curve [AUC]) of 0.822 (95% CI: 0.781, 0.864). Construct validity evaluation by exploratory factor analysis (EFA) led to extraction of two factors from 11 items ("breast shape changes" and "breast pain and lump"), and the confirmatory factor analysis (CFA) confirmed the adequacy of extracted construct from EFA. Latent class analysis for evaluating of construct validity led to extracting three classes from participants (high [12.83%], moderate [60.97%], and low [26.2%]) in terms of awareness levels about early warning signs of breast cancer. All item-scale correlation coefficients exceeded the set value of 0.40, indicating satisfactory convergent validity. No ceiling and floor effects were detected. SEM and SDC were found to be 0.85 and 2.36, respectively. CONCLUSIONS The Persian version of BCAM is a reliable and valid instrument for monitoring levels of breast cancer awareness in general women population, also it can be used for evaluating the impacts of interventions attempting to raise breast cancer awareness.
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Affiliation(s)
- Zahra Heidari
- Endocrine and Metabolism Research Center and Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Endocrine and Metabolism Research Center and Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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